Office of Safety and Security Employment Application
Date of Application
*
-
Month
-
Day
Year
Date
Name
*
First Name
Middle Name
Last Name
Suffix
Preferred name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email Address
*
example@example.com
Type of Employment Desired
*
Full-Time
Part-Time
PRN - as needed
Shift preference (click all that apply)
*
First Shift (7-3)
Second Shift (3-11)
Third Shift (11-7)
Date Available for Employment
-
Month
-
Day
Year
Date
Are you legally eligible for employment in this country?
*
Yes
No
Are you able to perform the essential functions of the job for which you are applying (with or without reasonable accommodation?)
*
Yes
No
Employees must be over 21 to drive a college vehicle. Are you over 21?
*
Yes
No
Employees must have a valid driver's license to drive a college vehicle. Do you have a valid driver's license?
*
Yes
No
Have you ever pleaded "guilty" or "no contest" to, or been convicted of a crime? *
*
Yes
No
*
Answering yes to the question above does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation and rehabilitation will be taken into account.
Educational Background
Education
*
Rows
Name and Address of Institution
Degree/Hours Completed
High School
Vocational
College/Undergraduate
Graduate School
Honor/Rank/Special Awards/Citations Received
(Indicate Service Awards, Valedictorian, Magna/Summa/Cum Laude, Scholar, Dean's List, etc)
Back
Next
Employment History
Please indicate N/A if not applicable
*
Rows
(Start from most recent)
Name of Employer
Address
Telephone No.
Employment Dates
Position Held
Scope of Work
Supervisor and Position
Reasons for Leaving
Please indicate N/A if not applicable
Rows
(Start from most recent)
Name of Employer
Address
Telephone No.
Employment Dates
Position Held
Scope of Work
Supervisor and Position
Reasons for Leaving
Please indicate N/A if not applicable
Rows
(Start from most recent)
Name of Employer
Address
Telephone No.
Employment Dates
Position Held
Scope of Work
Supervisor and Position
Reasons for Leaving
Please indicate N/A if not applicable
Rows
(Start from most recent)
Name of Employer
Address
Telephone No.
Employment Dates
Position Held
Scope of Work
Supervisor and Position
Reasons for Leaving
Special Qualifications
(ex. Computer/Software Skills, Previous Security Experience, Customer Service Skills, etc.)
REFERENCES
*
Rows
Name
Position /Company
Relation
Contact No.
Reference 1
Reference 2
Reference 3
Submit
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