Fillable Lourdes Application For Employment For Website Final

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Lourdes Application For Employment For Website Final

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Application for Employment for
Lourdes University
PERSONAL INFORMATION:
Legal Name: Date:
Address:
Preferred Telephone Number:
Preferred e-mail:
Are you 18 years of age or older? Yes No
Are you either a U.S. citizen or an alien authorized to work in the U.S.? Yes
Please list all the names you may have used for previous employment or school:
No
N/A
Expected compensation: $
Are you related to anyone working for Lourdes? No Yes (name)
Have you previously worked for Lourdes? Yes No
If yes, please, provide dates: From: To:
Have you been convicted of a crime or violation other than a minor traffic infraction?
If yes, please explain:
Yes No
(Please note: a conviction record will not necessarily be a bar to employment. Factors such as the nature or gravity of any
offense or conduct; the time elapsed since the conviction and/or completion of any jail sentence; and the responsibilities
of the job being filled)
Have you ever had a license or certification revoked? Yes No
If yes, please explain:
1
POSITION APPLYING FOR:
Position: Date available:
How did you learn about this opening?
PROFESSIONAL REFERENCES:
Name:
Email:
Position or Title:
Phone Number:
Years Known:
Name:
Email:
Position or Title:
Phone Number:
Years Known:
Name:
Email:
Position or Title:
Phone Number:
Years Known:
EDUCATION:
High School:
Technical School:
College/University
Graduated
Graduated
Yes
Yes
No
No
Bachelor’s:
Graduated
Yes No
Master’s:
Graduated? Yes No
Doctoral:
Graduated? Yes No
Post-Doctorate:
Graduated? Yes No
Other Education/Training:
Graduated? Yes No
2
WORK EXPERIENCE:
Please list previous employment for the past 10 years, up to the latest four jobs, beginning with the most recent:
Employer: From: to:
Address:
Position Held: Reason for leaving:
Supervisor’s Name/Title: May we contact? Yes No
Description of Duties:
Employer: From: to:
Address:
Position Held: Reason for leaving:
Supervisor’s Name/Title: May we contact? Yes No
Description of Duties:
Employer: From: to:
Address:
Position Held: Reason for leaving:
Supervisor’s Name/Title: May we contact? Yes No
Description of Duties:
3
WORK EXPERIENCE CONTINUED:
Employer:
Address:
Position Held:
Supervisor’s Name/Title:
From:
Reason for leaving:
May we contact? Yes
to:
No
Description of Duties:
Authorization and Acknowledgements
I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE; I
UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACT
ON THIS APPLICATION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS)
WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF
EMPLOYMENT, REGARDLESS OF WHEN OR HOW DISCOVERED.
It is the policy of Lourdes University to afford equal opportunity to all employees and applicants for
employment without regard to age, race, religion, color, sex, sexual orientation, national origin,
genetic information, marital status, expunged juvenile records, or pregnancy. It is the policy of
Lourdes University to afford equal opportunities to disabled veterans, veterans of the Vietnam era,
and individuals with a disability, any and other characteristic protected by Federal, State or Local law.
I authorize the investigation of all statements and information contained in this application. I release
from all liability anyone supplying such information and I also release Lourdes University from all
liability that might result from making an investigation.
I acknowledge that I have read and understand the above statements and hereby grant permission to
confirm the information supplied on this application by me.
Applicant's Signature: Date:
Press the button below to clear all form data.
To submit the form, save the form and attach to email along with any other documents to
resume@lourdes.edu
4
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Lourdes Application For Employment For Website Final

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Completed 22 July 2020

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