Revised: 10/01/2018
Staff Applicant Eligibility Certification
Applicant Name:
Position Title:
Position Number:
Minimum
Qualifications:
(Cut and paste minimum
qualifications from job
posting.)
APPLICANT BACKGROUND VERIFICATION INFORMATION
Education
Degree:
Institution/Location:
Date Awarded:
Non-UWF degrees: Applicant should request official, sealed transcript be mailed to Human Resources, 11000
University Parkway, Building 20E, Pensacola, FL 32514 OR emailed to hr@uwf.edu
for electronic
submissions.
Experience
Must certify experience to meet minimum qualifications.
Position Title:
Position Duties:
Revised: 10/01/2018
Experience (Continued)
Employment Dates:
Employer Name:
City, State:
Contact Name/Title/Date:
Position Title:
Position Duties:
Employment Dates:
Employer Name:
City, State:
Contact Name/Title/Date:
Position Title:
Position Duties:
Employment Dates:
Employer Name:
Revised: 10/01/2018
Experience (Continued)
City, State:
Contact Name/Title/Date:
Comments:
I certify that I verified the above education and experience requirements.
_____________________________ ___________________________ ________________
Printed Name Signature Date:
Selection Committee Members (if applicable)
Chairperson: ________________________________________
Members
______________________________________ ____________________________________
______________________________________ ____________________________________
______________________________________ _____________________________________