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MASTER APPLICATION FOR EMPLOYMENT (Umpqua Community College)

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Master Application for Employment page- 1 -
MASTER APPLICATION FOR EMPLOYMENT
CONTACT INFORMATION
Name ________________________________________________________________________
Address ______________________________________________________________________
City, State, Zip _________________________________________________________________
Phone_______________________________ or Phone 2 ________________________________
E-mail ________________________________________________________________________
EMPLOYMENT GOAL: _______________________________________________________
______________________________________________________________________________
Rate of Pay Expected $_____________per _______________
WORK EXPERIENCE: Start with your most recent job and work backwards
If you have no work history, list volunteer, charitable or non-paid experiences.
Job Title: ___________________________________________________________________
Organization/Company Name____________________________________________________
Address: _____________________________________________________________________
City: _________________State_______________Zip_____________Phone_______________
Supervisor’s Name: _________________________________________________________
Dates: from _________________________________to _______________________________
Salary: starting ___________________________ending______________________________
Reason for leaving ____________________________________________________________
Describe what you did on this job: _________________________________________________
______________________________________________________________________________
Accomplishments/awards/honors: __________________________________________________
______________________________________________________________________________
What did you like about this job? __________________________________________________
______________________________________________________________________________
What did you dislike about this job? ________________________________________________
______________________________________________________________________________
Master Application for Employment page- 2 -
WORK EXPERIENCE Continued use additional pages if needed for more jobs
Job Title: ___________________________________________________________________
Organization/Company Name____________________________________________________
Address: _____________________________________________________________________
City: _________________State_______________Zip_____________Phone_______________
Supervisor’s Name: ___________________________________________________________
Dates: from _________________________________to _______________________________
Salary: starting ___________________________ending______________________________
Reason for leaving ____________________________________________________________
Describe what you did on this job: _________________________________________________
______________________________________________________________________________
Accomplishments/awards/honors: __________________________________________________
______________________________________________________________________________
What did you like about this job? __________________________________________________
______________________________________________________________________________
What did you dislike about this job? ________________________________________________
______________________________________________________________________________
Job Title: ___________________________________________________________________
Organization/Company Name____________________________________________________
Address: _____________________________________________________________________
City: _________________State_______________Zip_____________Phone_______________
Supervisor’s Name: __________________________________________________________
Dates: from _________________________________to _______________________________
Salary: starting ___________________________ending________________________________
Reason for leaving ______________________________________________________________
Describe what you did on this job: _________________________________________________
______________________________________________________________________________
Accomplishments/awards/honors: __________________________________________________
______________________________________________________________________________
What did you like about this job? __________________________________________________
______________________________________________________________________________
What did you dislike about this job? ________________________________________________
______________________________________________________________________________
Master Application for Employment page- 3 -
WORK EXPERIENCE Continued use additional pages if needed for more jobs
Job Title: __________________________________________________________________
Organization/Company Name____________________________________________________
Address: _____________________________________________________________________
City: _________________State_______________Zip_____________Phone_______________
Supervisor’s Name: ___________________________________________________________
Dates: from _________________________________to _______________________________
Salary: starting ___________________________ending______________________________
Reason for leaving ____________________________________________________________
Describe what you did on this job: _________________________________________________
______________________________________________________________________________
Accomplishments/awards/honors: __________________________________________________
______________________________________________________________________________
What did you like about this job? __________________________________________________
______________________________________________________________________________
What did you dislike about this job? ________________________________________________
______________________________________________________________________________
Job Title: __________________________________________________________________
Organization/Company Name____________________________________________________
Address: _____________________________________________________________________
City: _________________State_______________Zip_____________Phone_______________
Supervisor’s Name: __________________________________________________________
Dates: from _________________________________to _______________________________
Salary: starting ___________________________ending________________________________
Reason for leaving ______________________________________________________________
Describe what you did on this job: _________________________________________________
______________________________________________________________________________
Accomplishments/awards/honors: __________________________________________________
______________________________________________________________________________
What did you like about this job? __________________________________________________
______________________________________________________________________________
What did you dislike about this job? ________________________________________________
______________________________________________________________________________
Master Application for Employment page- 4 -
WORK EXPERIENCE Continued use additional pages if needed for more jobs—going
back only 10 years
Job Title: ___________________________________________________________________
Organization/Company Name____________________________________________________
Address: _____________________________________________________________________
City: _________________State_______________Zip_____________Phone_______________
Supervisor’s Name: ___________________________________________________________
Dates: from _________________________________to _______________________________
Salary: starting ___________________________ending______________________________
Reason for leaving ____________________________________________________________
Describe what you did on this job: _________________________________________________
______________________________________________________________________________
Accomplishments/awards/honors: __________________________________________________
______________________________________________________________________________
What did you like about this job? __________________________________________________
______________________________________________________________________________
What did you dislike about this job? ________________________________________________
______________________________________________________________________________
Job Title: ___________________________________________________________________
Organization/Company Name____________________________________________________
Address: _____________________________________________________________________
City: _________________State_______________Zip_____________Phone_______________
Supervisor’s Name: __________________________________________________________
Dates: from _________________________________to _______________________________
Salary: starting ___________________________ending________________________________
Reason for leaving ______________________________________________________________
Describe what you did on this job: _________________________________________________
______________________________________________________________________________
Accomplishments/awards/honors: __________________________________________________
______________________________________________________________________________
What did you like about this job? __________________________________________________
______________________________________________________________________________
What did you dislike about this job? ________________________________________________
______________________________________________________________________________
Master Application for Employment page- 5 -
EDUCATION AND TRAINING
High School or GED : Name and Address __________________________________________
_____________________________________________________________________________
______________________________________________________________________________
Year Graduated __________________
or Number of years completed ___________________and years attended __________________
In what subjects did you do best? __________________________________________________
_____________________________________________________________________________
What subjects did you like most? __________________________________________________
_____________________________________________________________________________
What subjects did you like least? __________________________________________________
_____________________________________________________________________________
College or Universities: Names and Addresses _______________________________________
______________________________________________________________________________
______________________________________________________________________________
Year Graduated __________________
or Number of years completed _____________________ and years attended ________________
Degrees/certificates earned: _______________________________________________________
Major: __________________________________Minor:________________________________
In what subjects did you do best? __________________________________________________
_____________________________________________________________________________
What subjects did you like most? __________________________________________________
_____________________________________________________________________________
What subjects did you like least? __________________________________________________
_____________________________________________________________________________
Training Programs
(Other Professional, technical, clerical, management, license. Certificate etc
Name and Addresses or location of training:-_________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Dates attended:_________________________________________________________________
Name of the Course_____________________________________________________________
Description of the Course_________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Certificate/License Earned _______________________________________________________
_____________________________________________________________________________
Use an additional page for each school attended or training program you completed
Master Application for Employment page- 6 -
SPECIAL SKILLS AND ABILITIES
Current licenses, credentials, accreditations;________________________________________
______________________________________________________________________________
Foreign languages/American sign language
Fluent in: _____________________________________________________________________
Knowledge of: _________________________________________________________________
Computer Hardware
Expert in:______________________________________________________________________
______________________________________________________________________________
Knowledge of: _________________________________________________________________
______________________________________________________________________________
Computer Software
Advanced user of:_______________________________________________________________
______________________________________________________________________________
Knowledge of __________________________________________________________________
______________________________________________________________________________
Machines/Equipment
Operate: ______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Clerical Skills:_________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Skills in Dealing with People:
_____________________________________________________________________________
_____________________________________________________________________________
Other Skills Please be Specific:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Master Application for Employment page- 7 -
MILITARY HISTORY
Branch of Service_____________________________________________________________
Dates served: From _____________to__________ Rank at Discharge___________________
Duties and/or Special Training_____________________________________________________
_____________________________________________________________________________
Security Clearance (if any) _______________________________________________________
Special Assignments of Campaigns _________________________________________________
______________________________________________________________________________
Decorations or Awards___________________________________________________________
______________________________________________________________________________
OTHER INFORMATION
Hobbies/interests:______________________________________________________________
______________________________________________________________________________
Memberships in Organizations/Volunteer/Community Activities
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
CRIMINAL BACKGROUND
Have you ever been convicted of a Felony? ___________
If so; what were the date(s)? ____________________________________________________
Please give a brief description of the offense (s) _______________________________________
______________________________________________________________________________
Have you ever been convicted of a Misdemeanor? _____________________________________
If so, what were the dates(s) ______________________________________________________
Please give a brief description of the offense (s) _______________________________________
This is illegal to ask on an application in the state of Oregon, unless directly related to the
job you are applying for. However, be prepared to answer this in an interview question or
if company conducts backgrounds checks as condition of employment.
Master Application for Employment page- 8 -
REFERENCES
Name_________________________________________________________________________
Address:______________________________________________________________________
City: __________________________State __________________Zip_____________________
Email Address:________________________________________________________________
Occupation:___________________________________________________________________
Relationship to You ____________________________________________________________
Name_________________________________________________________________________
Address:______________________________________________________________________
City: __________________________State __________________Zip_____________________
Email Address:________________________________________________________________
Occupation:___________________________________________________________________
Relationship to You ____________________________________________________________
Name_________________________________________________________________________
Address:______________________________________________________________________
City: __________________________State __________________Zip_____________________
Email Address:________________________________________________________________
Occupation:___________________________________________________________________
Relationship to You ____________________________________________________________
Master Application for Employment page- 9 -
REFERENCES Cont.
Name_________________________________________________________________________
Address:______________________________________________________________________
City: __________________________State __________________Zip_____________________
Email Address:________________________________________________________________
Occupation:___________________________________________________________________
Relationship to You ____________________________________________________________
Name_________________________________________________________________________
Address:______________________________________________________________________
City: __________________________State __________________Zip_____________________
Email Address:________________________________________________________________
Occupation:___________________________________________________________________
Relationship to You ____________________________________________________________
Name_________________________________________________________________________
Address:______________________________________________________________________
City: __________________________State __________________Zip_____________________
Email Address:________________________________________________________________
Occupation:___________________________________________________________________
Relationship to You ____________________________________________________________
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MASTER APPLICATION FOR EMPLOYMENT (Umpqua Community College)

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Completed 26 July 2020

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