Fillable Employment Employment Application.PDF

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Employment Employment Application.PDF

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The Employment Employment Application.PDF form is 3 pages long and contains:

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Country of origin: US
File type: PDF

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HAMPTON UNIVERSITY
HAMPTON, VIRGINIA 23668
OFFICE OF THE PROVOST
APPLICATION FOR EMPLOYMENT Date of Application:
Name:
LAST FIRST MIDDLE
Address:
STREET CITY STATE ZIP CODE
Telephone Numbers: Home ( ) Work ( ) SS#
Are you a U.S. citizen? Yes No If "No," type of Visa:
Have you been previously employed at Hampton University? Yes No
If "Yes," please complete the following:
Dates: From: To:
Department: Title:
Do you have any relatives employed at Hampton University? Yes No
If "Yes, please complete the following: Name:
Department: Relationship:
Have you ever been convicted of any crime? (Do not include minor traffic tickets) Yes No
If "Yes," please explain:
Reset
2
ACADEMIC TRAINING:
Undergraduate
Major Minor Degree
Name and Address of Institution Subjects Subjects and Date
Graduate School
Major Minor Degree
Name and Address of Institution Subjects Subjects and Date
Professional Status (Law, CPA, or other degrees held):
Honorary Degree Institution
List foreign languages you: Speak Read Write How Fluently
List Scholastic Honors (Prizes, Scholarships, Fellowships, Honorary, Fraternities - Graduate and Undergraduate):
List post-doctoral fellowships, exchange positions, civilian government service etc.:
List memberships in learned professional societies:
Have you had any books, articles, music, major book reviews, papers, etc. published? Have you exhibited paintings,
sculpture, or other work? Yes No If "Yes," please attach list.
3
OCCUPATIONAL RECORD (Start with your last position and work back. If you were ever employed in any position
under a different name, give in each position, the name used.)
Institution/Organization Position Final
Organization Location or Title From To Salary
Reason for wanting to leave your present position:
Do you object to having your present employer questioned about your work? Yes No
Have you ever been discharged or forced to resign from a position? Yes No
If "Yes," please list date, name and address of employer and explain:
What is your reason for seeking employment at Hampton University?
List Military Service (with dates):
In what extracurricular activities do you participate?
I am applying for a position in with the rank of
I am also prepared to teach (List subjects):
I will accept: Full-time Part-time Either (Check one)
ADDITIONAL REMARKS:
Give name, address and telephone number of three references who are not related to you and are not previous employers.
4
I authorize persons, schools, my present employer (if applicable), and any previous employer or organization named in this
application (and accompanying resume, if any) to provide any relevant information requested by Hampton University in
order that Hampton University can arrive at an employment decision.
I hereby affirm that the information provided on this application for employment (and accompanying resume), if any, is true
and complete to the best of my knowledge. I agree that falsified information or significant omissions may disqualify me
from further consideration for employment and may be considered justification for dismissal if discovered at a later date.
Hampton University is an Equal Opportunity Employer. The Civil Rights Act of 1964 and state and local laws prohibit
discrimination on the basis of race, color, religion, sex or national origin. In addition, state and local laws prohibit
discrimination on the basis of disability and age, and the Age, Discrimination and Employment Act, and some state and local
laws prohibit discrimination on the basis of age with respect to individuals who are at least 40 years of age. It is our policy to
comply fully with these acts and information requested on this application will not be used for any purpose prohibited by law.
U.S. law requires that, if hired, you must furnish your social security card and one of the following documents within
seventy-two (72) hours of starting work:
1. A card issued by federal, state or local government showing your identity.
2. Driver’s license or state-issued ID card with photo.
3. Current INS forms with employment authorization stamp.
4. Voter registration card.
5. U.S. Military Card or other draft card.
If for some reason you do not have a social security card, you may present an original or a copy of a U.S. birth certificate, or
Department of State Forms FS-545 or DS-1350 or INS Forms I-327, I-571, I-197, I-179.
This application is current only for thirty (30) days, at the conclusion of which, if you have not heard from us and still wish to
be considered for employment, it will be necessary for you to fill out a new application.
Signature: Date:
(Failure to sign above or to answer all questions on this application may result in loss of employment opportunities at
Hampton University)
(6-10-98)
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Completed 8 July 2020

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