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Staff-application - ju-employment-application

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  • 30 check-boxes
  • 97 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Jacksonville University

BROWSE JACKSONVILLE UNIVERSITY FORMS

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An Equal Opportunity Employer
APPLICANTS ARE CONSIDERED FOR OPEN POS
ITIONS WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER, NATIONAL ORIGIN,
AGE, MARITIAL STATUS, VETERAN STATUS, SEXUAL ORIENTATION, GENDER IDENTITY, OR THE PRESENCE OF A DISABILITY.
PLEASE PRINT
Name (Last, First, Middle)
Application Date:
Have you ever been employed under a different name? If so,
please state name(s):
Email Address:
Mailing Address:
City:
State:
Zip:
Social Security Number:
Are You at least 18 years of age? Yes No
Are you legally eligible for employment in the U.S.? Yes No
Proof of eligibility for employment will be required upon employment.
Position Applied For:
Date Available:
Salary Requirement:
Status Desired:
Full-Time
Part Time
Are you available and willing to work overtime? YES NO
Please state any hours or days you are unavailable to work:
Referral Source: Advertisement Friend Relative
Other (Please identify referral source)
Veteran of U.S. Military Service? YES NO
Have you been previously employed by Jacksonville University? YES
NO
If yes, dates: From: To:
Do you have reliable transportation to and from
work? YES
NO
Are you related to anyone employed by the University? YES NO
If YES, please provide name:
Do you agree to abide by the University Rules?
YES
NO
IF YOU OMIT OR FALSIFY REQUESTED INFORMATION IN YOUR RESPONSE TO ANY OF THESE QUESTIONS, YOUR
APPLICATION MAY BE DISQUALIFIED FROM CONSIDERATION OR YOU MAY BE DISCHARGED, IF HIRED.
HRD 5/00
S
TAFF E
MPLO
YMENT
APPL
ICA
T
ION
Have you read the posted job
description?
YES
NO
Are you able to perform the essential functions of the job as described in the posted
description? YES NO If NO, explain.
EMPLOYMENT EXPERIENCE
Start with your present or last job. Must Be Completed
1
Employer:
Dates Employed:
Work Performed:
From
To
Address:
Job Title:
Hourly Rate/Salary
Starting
Final
Supervisor & Title: Telephone No.:
Reason for Leaving:
May we contact this employer? YES NO
2
Employer:
Dates Employed:
Work Performed:
From
To
Address:
Job Title:
Hourly Rate/Salary
Starting
Final
Supervisor & Title: Telephone No.:
Reason for Leaving:
May we contact this employer? YES NO
3
Employer:
Dates Employed:
Work Performed:
From
To
Address:
Job Title:
Hourly Rate/Salary
Starting
Final
Supervisor & Title: Telephone No.:
Reason for Leaving:
May we contact this employer? YES NO
4
Employer:
Dates Employed:
Work Performed:
From
To
Address:
Job Title:
Hourly Rate/Salary
Starting
Final
Supervisor & Title: Telephone No.:
Reason for Leaving:
May we contact this employer? YES NO
SPECIAL SKILLS
Summarize special skills and qualifications acquired from employment, military, or other experience or training which may be directly transferable to the
job for which you are applying:
EDUCATION
Circle highest grade completed.
Grade School: 1 2 3 4 5 6 7 8 High School: 9 10 11 12 College: 1 2 3 4 Graduate: 1 2 3 4
Name of High School:
Location:
Major:
Degree:
Dates of Attendance:
Name of College:
Location:
Major:
Degree:
Dates of Attendance:
Name of Graduate School:
Location:
Major:
Degree:
Dates of Attendance:
Name of Vocational School:
Location:
Major:
Degree:
Dates of Attendance:
List formal or other specialized training programs attended:
PROFESSIONAL REFERENCES
Name
Occupation:
Address:
Phone Number:
( )
( )
( )
AGREEMENT
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 will be sufficient 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 and obtain information from all references, employers (except as
limited by me herein), or any other persons or agencies having information that will assist Jacksonville University in evaluating my suitability for employment. I request
any duly constituted law enforcement agency or judicial officer 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.
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 offered employment with the University and that any offer 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 qualified applicant for
employment.
5. Applicants accepted for employment should understand that while Jacksonville University makes every effort to provide steady employment, the University cannot guarantee the
permanence of any position. Job tenure can be affected by many factors, including economic conditions, changes in laws, University policies, conformity to work rules, job
performance, etc. Jacksonville University operates under the Employment At Will statute of the State of Florida. I further understand that no oral promise, University policy,
custom, business practice or other procedure (including the University’s Employee Handbook or any personnel manuals) constitutes an employment contract or modification of
the at-will employment relationship between me and the University.
The contents of any employee handbook or personnel manuals, as well as other University policies and practices, are subject to change or modification by the University, solely
at its discretion, without notice. I also understand that no supervisor or other official of the University (except it Chief Executive Officer, in writing) has the authority to enter into
any agreement with me or to make any agreement contrary to the foregoing.
6. This application will remain active for ninety (90) days. If you wish to be considered for another position you may contact the Office of Human Resources at 256-7025.
Applicants needing accommodations, due to a disability, in connection with applying for a position, should contact the Office of Human Resources at 256-7025.
This is to certify that I have read, understand, and agree with all items listed above.
_________________________________________________________
____________________
Applicant’s Signature
Date
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Staff-application - ju-employment-application

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Completed 10 February 2020

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