Supervisor Human Resources
Resume:
FACULTY EMPLOYMENT
APPLICATION
AN EQUAL OPPORTUNITY EMPLOYER
APPLICANTS ARE CONSIDERED FOR OPEN POSITIONS WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX,
NATIONAL ORIGIN, AGE, MARTIAL STATUS, VETERAN STATUS, 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:
Are you legally eligible for employment in the U.S.? YES NO
Home Phone: Social Security Number:
Work Phone: Proof of employment eligibility will be required upon employment.
Position Applied For:
Status Desired: Preferred Course Assignments:
F ULL-TIME PART-TIME
Are you able to perform the essential functions of the job? YES NO If no, explain
Have you ever been convicted of a crime other than a minor traffic violation, served a jail sentence or period of probation subject to a plea
bargain agreement, a plea of nolo contenders, or a court order of adjudication withheld? YES NO If yes, explain ( This information will
be considered only in relation to specific job requirements.)
Membership in Learned and Professional Societies: ______________________________________________________________________
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Publications: ______________________________________________________________________________________________________
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Plans for Advanced Study, Research, Consulting, and Publication: __________________________________________________________
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EDUCATION
Institutions Attended: Dates of Attendance Major Minor Degrees Received/Date
Doctoral Dissertation Title:
Honors and Distinctions, including Honorary Societies:
EMPLOYMENT EXPERIENCE
Start with your present or most recent job
Employer: Date Employed: Responsibilities:
From To
Address:
Supervisor, Title & Phone Number: Salary:
Starting Final
YES NO
May we contact this employer?
Reason for Leaving:
Employer: Date Employed: Responsibilities:
From To
Address:
Supervisor, Title & Phone Number: Salary:
Starting Final
YES NO
May we contact this employer?
Reason for Leaving:
Employer: Date Employed: Responsibilities:
From To
Address:
Supervisor, Title & Phone Number: Salary:
Starting Final
YES NO
May we contact this employer?
Reason for Leaving:
Employer: Date Employed: Responsibilities:
From To
Address:
Supervisor, Title & Phone Number: Salary:
Starting Final
YES NO
May we contact this employer?
Reason for Leaving:
SPECIAL SKILLS AND EXPERIENCE
Administrative Experience __________________________________________________________________________________________
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PROFESSIONAL/PERSONAL REFERENCES
List people other than relatives or former employers
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 may 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 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 officer to furnish Jacksonville University with all information at its disposal pertaining to any criminal conviction record on me. I
hereby release Jacksonville University and any law enforcement agency, judicial officer, or other individual from any liability arising from disclosure of
said information.
4. The contents of any faculty handbook or personnel manuals, as well as other University policies and practices, are subject to change or modification by
the University. I also understand that no supervisor or other official of the University (except its Chief Executive Officer) in writing has the authority
to enter into any agreement with me or to make any agreement contrary to the foregoing.
5. This 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-***-****.
I certify that I have read, understand, and agree with all items listed above.
________________________________________ ____________________
Applicant’s Signature Date
Contact this candidate