SPECIAL SKILLS AND EXPERIENCE
Administrative Experience __________________________________________________________________________________________
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PROFESSIONAL/PERSONAL REFERENCES
Name & Occupation: A :rebmuN enohP:sserdd
List people other than relatives or former employers
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1. I certify that all information provided herein is true and complete to the best of my knowledge.
2. I understand that any false statements or omission of information in this application may be sucient cause for disqualifying my application from
consideration or, if hired, for discharge.
3. I hereby authorize Jacksonville University to verify all statements contained in this application, and to contact all references, employers (except as
limited by me herein), or any other persons or agencies having information relative to such statements. I request any duly constituted law enforcement
agency or judicial ocer to furnish Jacksonville University with all information at its disposal pertaining to any criminal conviction record on me. I
hereby release Jacksonville University or other individual from any liability arising from disclosure of said information.
5. e contents of any faculty handbook or personnel manuals
, as well as other University policies and practices, are subject to c hange or modication by
the Universit
y. I also understand that no supervisor or other ocial of the University (except its Chief Executive Ocer) in writing has the authority
to enter into any agreement with me or to make any agreement contrary to the foregoing.
6. is application will remain active for ninety (90) days. Any applicant wishing to be considered for employment beyond ninety (90) days should
reapply. Applicants needing accommodations due to disability in connection with applying for a position should contact the Human Resources
Department at (904) 256-7025.
I certify that I have read, understand, and agree with all items listed above.
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4. I understand that Jacksonville University has not requested information regarding the existence of a criminal background at this time. However, I
understand that Jacksonville University conducts background checks on all individuals oered employment with the University and that any oer of
employment will be conditioned on the result of a background investigation. I further understand that certain information in the background check may
disqualify me from employment even if I am otherwise the most qualied applicant for employment.
Applicant’s Signature Date
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