Lindsey Wilson University
Secure Network
Application for Employment
An Equal Opportunity Employer
Applicants are considered for employment without regard to race, color, religious beliefs, sex, sexual orientation, genetic information, national origin, age, disability, non-job-related medical condition, marital or veteran status, amnesty, or any other legally protected status.
Name
First Name:
Middle Name:
Last Name:
Address
Street:
City:
County:
State:
Zip:
Contact
Primary Phone:
Secondary Phone:
Email Address:
General Information
Are you eligible to work in the U.S.?
Yes
No
Do you have a driver's license?
Yes
No
Does anyone in your immediate family work here?
Yes
No
Please list name(s), relationship(s).:
Work Preferences
Position(s) applying for:
Date available for work:
Type of employment desired?
Full-Time
Part-Time
Temporary/Seasonal
Will you perform shift work?
Yes
No
Can you travel, if job requires it?
Yes
No
List any travel restrictions:
Minimum salary requirement:
List any work restrictions:
High School
High School Name:
Years Completed:
Did you graduate?
Yes
No
Degree/Diploma:
Business/Technical
Business/Technical School Name:
Hours Completed:
Did you graduate?
Yes
No
Degree/Diploma:
College/University
College/University Name:
Hours Completed:
Did you graduate?
Yes
No
Degree/Diploma:
Graduate/Study
Graduate/Study School Name:
Hours Completed:
Did you graduate?
Yes
No
Degree/Diploma:
Other
Other Education Name:
Hours Completed:
Did you graduate?
Yes
No
Degree/Diploma:
Employment History
Employer 1
Employer:
Address:
Telephone Number:
Job Title:
Supervisor Name & Title:
May we contact?
Yes
No
Start Date:
End Date:
Reason for Leaving:
Summarize job responsibilities and duties performed:
Employer 2
Employer:
Address:
Telephone Number:
Job Title:
Supervisor Name & Title:
May we contact?
Yes
No
Start Date:
End Date:
Reason for Leaving:
Summarize job responsibilities and duties performed:
Employer 3
Employer:
Address:
Telephone Number:
Job Title:
Supervisor Name & Title:
May we contact?
Yes
No
Start Date:
End Date:
Reason for Leaving:
Summarize job responsibilities and duties performed:
Employer 4
Employer:
Address:
Telephone Number:
Job Title:
Supervisor Name & Title:
May we contact?
Yes
No
Start Date:
End Date:
Reason for Leaving:
Summarize job responsibilities and duties performed:
Special Considerations
List any skills and/or abilities that you possess that will be helpful in doing the job applied for:
References
Reference 1
Reference Name:
Email Address:
Phone:
Reference 2
Reference Name:
Email Address:
Phone:
Reference 3
Reference Name:
Email Address:
Phone:
Additional Information
Upload Additional Documents (Resume, Cover Letter, etc.):
Drag and drop files here or click "Choose Files" to select multiple documents.
Document Upload Policy: For security and processing purposes, the total size of all uploaded documents must not exceed 20 MB.
Additional Comments:
PLEASE READ THE FOLLOWING BEFORE COMPLETING APPLICATION
(Required)
I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this employment application and additional job-related background investigation as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. I understand that neither this document nor any verbal promises made by the employer or representative employee may be constituted as an employment contract. I understand and acknowledge that, unless otherwise defined by law, policies and procedures, or rules and regulations, any employment relationship with this organization is of an "at-will" nature, which means that either the employee or employer may terminate the employment relationship at any time, with or without cause or advance notice. I understand that this application is the property of the employing organization.
