Employment Application
Position you are applying for _____________________________________________Date of Application ______________________
Where did you hear about this position? ___________________________________________________________________________
Personal Data
Name ___________________________________________________ E-mail Address _____________________________________
Address _________________________________________________ City, State, Zip _____________________________________
Primary phone Number _____________________________________ Other phone _______________________________________
Have you ever worked for Cobleskill or SUNY? No Yes If Yes, give particulars: __________________________________
List any other names you may have gone to school or worked under: ____________________________________________________
Education (List from most current)
Degree or Certification Major Course(s) of Study Institution/Date Obtained
Job Data (List from most current and PLEASE DO NOT WRITE “SEE RESUME”)
Current/Last Employer ______________________________________________________Dates of Service ___________________
Illustrative Job Title and/or Summary of duties _____________________________________________________________________
Employer __________________________________________________________________Dates of Service ___________________
Illustrative Job Title and/or Summary of duties _____________________________________________________________________
Employer __________________________________________________________________Dates of Service ___________________
Illustrative Job Title and/or Summary of duties _____________________________________________________________________
(List name and contact info for at least three individuals who can speak to your professional work-related behaviors)
1: Current or latest supervisor: ___________________________________________________________________________________
2: Former supervisor: __________________________________________________________________________________________
3: _________________________________________________________________________________________________________
4: _________________________________________________________________________________________________________
5: _________________________________________________________________________________________________________
Comments (include here any employer you do NOT wish us to contact and why): _________________________________________
Applicant must complete all information requested above as well as all information listed
on the Employment Application Checklist or your application will be considered incomplete
and you may not be given consideration for employment
Human Resources Department
208 Knapp Hall
Cobleskill, NY 12043
(518) 255-5423 (voice)
(518) 255-5657 (fax)
SUNY Cobleskill Employment Instructions and Checklist
Checklist of materials required to complete your application
Employment Application
Resume and cover letter
Preemployment Certification Form
Equal Employment Opportunity Data Collection Sheet (optional)
Transcripts from all post-secondary institutions only if requested in job announcement
(copies are accepted for application; OFFICIAL transcripts required upon hire.)
Application Process at SUNY Cobleskill
Cobleskill considers only those applications submitted for a specific posted position. Unsolicited resumes
or application materials are discarded after 30 days. We do NOT maintain an applicant database, so
applicants applying to multiple jobs must submit multiple applications at the time of the job posting.
Applications are reviewed by a position search committee which is exclusively responsible for determining
applicant eligibility for an open position based on posted job requirements.
Applicants are typically contacted for a telephone interview first and finalists are invited to campus for in-
person interviews which occur in a group setting. In addition to a traditional interview, academic
applicants may be required to give a teaching demonstration in their area of application. Administrative
applicants typically appear in an open forum setting to answer questions from the general college
Recruitment for open positions may begin months before the position actually becomes available.
Applicants are strongly encouraged to contact Human Resources at (518) 255-5423 to check on the status
of their application and to ensure that all application materials have been submitted.
Forward all application materials to:
State University of New York
Human Resources Department
106 Suffolk Circle
Cobleskill, NY 12043
(518) 255-5423 (voice)
(518) 255-5657 (fax)
SUNY Cobleskill is an Affirmative Action/Equal Opportunity educational
institution. It is guided by the principle that equal opportunity means more than
equal employment opportunity, and that access to facilities and services shall be
available to all people regardless of their race, color, religion, sex, national
origin, age, veteran status, disability, marital status, or sexual orientation. This
principle is applicable to every member of the SUNY Cobleskill community, both
students and employed personnel at every level, and to all facilities and services.
Cobleskill employs United States citizens and persons lawfully authorized to work in the United States.
All qualified individuals are encouraged to apply.
Individuals with disabilities requiring accommodation during the hiring process should notify
the Human Resources Office at (518) 255-5514 by the filing deadline.
Para la traducción de, o ayuda con, cualquier material de esta solicitud, pongasé en contacto
con el departamento de Recursos Humanos al (518) 255-5514
All candidates interviewed for academic and administrative faculty positions must execute the following
certification as a condition of being considered for employment. Failure to submit a timely certification
when requested may result in disqualification from employment consideration.
Certification of Credentials & Qualifications
I certify that all application materials submitted for employment consideration (e.g., letter of interest,
curriculum vitae or application, educational and employment records, publications, or work samples) are a
true, accurate, and complete representation of my credentials and qualifications. I understand that degrees
offered in support of my candidacy must be issued by an institution accredited by a regional, national,
professional, or specialized accrediting body and that degrees issued outside the U.S. must be evaluated for
equivalency to U.S. degrees.
Acknowledgement of Responsibility to Obtain/Maintain Eligibility to Work in the United States
I understand SUNY Cobleskill employs only individuals who are lawfully eligible to work in the United
States and that employment eligibility will be verified upon employment. If I do not currently have
permanent eligibility to work in the U.S., I understand that it is my responsibility to obtain and/or maintain
eligibility to work and that loss of eligibility to work at any future date will invalidate my employment
relationship and result in concurrent separation from employment without recourse or appeal.
Certification or Disclosure Pertaining to Criminal Convictions
I understand that in selected circumstances, convictions for a misdemeanor, gross misdemeanor, or felony
related to the duties and responsibilities of a given position may influence consideration for employment. I
certify that unless I have listed below a statement about the dates, charges, and circumstances of any such
convictions, I have not been convicted of a misdemeanor, gross misdemeanor, or felony in any jurisdiction
inside or outside the U.S.
Authorization to Verify Application Materials
I understand that any falsification, misrepresentation, or material omission in my application materials
(including this certification) or making other false or fraudulent representations in securing employment
may be grounds for disqualification of my candidacy or may be grounds for termination if discovered after
the date of hire.
My signature below authorizes SUNY Cobleskill to verify all of my application materials including
contacting listed references as well as validating educational and employment records, with the
understanding that facsimiles or photocopies of this authorization shall be deemed as valid as the original.
If submitted electronically, I acknowledge and agree that by typing my name on the signature line, I am
authorizing and validating the statements above to the same degree as my original signature.
Signature of Candidate: __________________________________________________________________
Printed Name of Candidate: ______________________________________________________________
Date: ______________________________
Position Applied For: ____________________________________________________________________
Name in which degree(s) issued (if different): ________________________________________________
click to sign
click to edit
Equal Employment Opportunity Data Collection Sheet
Completion of this form is optional and will in no way affect your application.
To help us comply with federal/state equal employment opportunity reporting requirements, we ask that
applicants complete the following questions. This pre-employment form is not part of the application for
employment and is maintained in a confidential file separate from the application. Data is used for
statistical purposes and to measure effectiveness of recruitment efforts.
Title of Job Applied for: _________________________________Date of Application: _____________
Name _______________________________________________Social Security # ___________________
Please complete as indicated:
Male Female
AGE: Date of Birth: ___________________________
White ( Not of Hispanic Origin) - All persons having origins in any of the original peoples of
Europe, North Africa, or the Middle East.
Black (Not of Hispanic Origin) - All persons having origins in any of the Black racial groups of
Hispanic - All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other
Spanish culture or origin, regardless of race.
Asian or Pacific Islander - All persons having origins in any of the original peoples of the Far
East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for
example: China, India, Japan, Korea, the Philippine Islands, Samoa and Hawaii.
American Indian or Alaskan Native – All persons having origins in any of the original indigenous
peoples of North America, and who maintain cultural identification through tribal affiliation or
community recognition.
No Yes I consider myself to be an individual with a disability.
Please check any and all categories that apply to you.
1. A veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to
compensation under laws administered by the Department of Veteran Affairs for a disability.
a. Rated at 30 percent or more; or
b. Rated at 10 or 20 percent in the case of a veteran who has been determined under section 1506 of Title 38,
U.S.C., to have a serious employment handicap: or
2. A person who was discharged or released from active duty because of a service-connected disability.
1. A person who served more than 180 days of active military, naval, or air service, any part of which was during the period
of August 5, 1964 through May 7, 1975; and
2. Was discharged or released with other than a dishonorable discharge, or
3. Was discharged or released from active duty because of a service-connected disability.