Welcome to the State University of New York Polytechnic Institute (SUNY Poly). We appreciate your interest in our organization. We
encourage you to provide all the information requested on this application. Thank you.
We are an equal opportunity/affirmative action employer. Personnel are chosen on the basis of ability. SUNY Poly will not discriminate in its
employment practices due to an applicant’s race, creed, religion, color, citizenship, national origin, sex, age, sexual orientation, predisposing
genetic characteristics, gender identification, genetic information, familial status, marital status, pregnancy, status as a domestic violence victim,
criminal conviction, disability, military status, disabled veteran, recently separated veteran, Armed Forces Service Medal veteran, active duty or
wartime campaign badge veteran, or other characteristic as protected by law, in accordance with federal and state law.
The University’s policy is in accordance with federal and state laws and regulations prohibiting discrimination and harassment. These laws
include the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972,
Title VII of the Civil Rights Act of 1964 as Amended by the Equal Employment Opportunity Act of 1972 and the New York State Human Rights
Law. These laws prohibit discrimination and harassment, including sexual harassment and sexual violence.
Inquiries regarding the application of Title IX and other laws, regulations and policies prohibiting discrimination may be directed to the Title IX
Coordinator TitleIX@sunypoly.edu at SUNY Polytechnic Institute. Inquiries may also be directed to the United States Department of Education’s
Office for Civil Rights, 32 Old Slip 26th Floor, New York, NY 10005-2500; Tel. (646) 428-3800; Email OCR.NewYork@ed.gov.
Invitation for self-identification - individuals with disabilities and veterans who wish to benefit under the affirmative action program are invited
to identify themselves. These forms are available at the location listed below. This information is strictly voluntary and will be kept confidential.
Refusal to provide it will not subject the applicant or employee to any adverse treatment, and it will be used only in accordance with government
Posting Reference Number:
Alternate Telephone Number
Type of Employment Desired:
Full-time Part-time Temporary
Are you CURRENTLY, or have you been, employed at SUNY Poly, SUNY CNSE, SUNYIT or any other public employer in the State of
YES NO If yes, list agency and dates. Retired? YES NO
As a result of prior employment with a public employer in the State of New York are you receiving a pension from a retirement system?
NOTE: NYS Law imposes strict limitations on those retired or intending to retire and draw a pension from a NYS public employment system.
YES NO If yes, list agency and dates.
Have you been employed by the Research Foundation for SUNY?
YES NO If yes, list location and dates.
Will you now or in the future require sponsorship for employment visa (e.g. H1-B)? Proof of identity and either U.S. citizenship or
Employment authorization are required prior to employment.
YES NO If yes, please provide dates and details.