Application for Employment – Brescia University

Personal

Name*

First MI Last Maiden/AKA

Date of Application*

Current Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Dates of Residence (from-to)*

Home Phone*

Business Phone

Cell/Message/Other Phone

Email*

Preferred method of contact

Position(s) Desired (DO NOT LIST 'ANY')*

Pay Expected*

Date Avaliable*

Please check all applicable options:*

Full-Time
Part-Time
Temporary Full-Time
Temporary Part-Time

Are you authorized to work in the U.S.?*

Yes
No

Proof of eligibility to work in the U.S. is required upon employment

Do you have any relatives who work for Brescia University? If yes, please give name and relationship:*

How did you learn of this opening?*

Education

Education Information*

School (High School, College/University, Other)	Name and Location of School	Course of Study	No. of Years Completed	Graduated (Yes/No)	Degree or Diploma Recieved

Please click the plus sign to add more rows.

Skills

Office Skills*

Maintenance Skills*

Job Related Licenses or Certificates

Type

Exp. Date

Professional Organization Membership(s)

Employment History

If you have a resume, you may attach; however, completion of this section is required. Attach additional sheets if necessary. Starting with your present or most recent job, account for all periods of time, unemployment and military service included. (All Applicants Must Account For The Last 10 Years).

Employment History

Company Name	From (month/year)	To (month/year)	Address	Starting job title	Ending job title	Supervisor's name and job title	Type of business	Pay starting	Pay ending	Reason for leaving	Phone No.	May we contact this employer?	Job titles and duties performed in this position

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Military Service

Complete this section if you served in the U.S. Armed Forces

Branch of Service

Active Period of Duty

From

Active Period of Duty

To

Date of Final Discharge

Current rank or rank at discharge

Describe your duties and any special training

General Information

Have you ever pled guilty or been convicted of a criminal offense?

Yes
No

(Conviction will not necessarily disqualify applicant from employment)

If yes, please list dates, offenses, and places:

Please indicate other information you think would be helpful to us in considering you for employment, such as special interests, activities, accomplishments, etc. (You may exclude all information indicative of age, sex, race, religion, color, national origin and disability.)

Personal References: Do not list relatives or employers*

Name	Address	Area Code & Phone No.	Occupation

Please click the plus sign to add more rows.

Applicant's Agreement and Certification

All material received through the application process becomes the property of Brescia University and will not be returned. I understand and agree that any relevant and material misrepresentation made on this application (including resume) will justify immediate dismissal if hired. I authorize Brescia University and/or their licensed agents to make any and all necessary and appropriate investigations to verify information in this application, including a check of criminal records, educational credentials, and work experience. I understand that references are obtained in confidence, and I waive my rights to view any reference(s) received by Brescia University and release providers of information from all liability in responding to inquiries about me. I understand that if hired by the employer, my employment may be terminated at any time by me or the employer with or without cause. I understand that no representative of the University has any authority to enter into an agreement for employment for any specified period of time. I understand that this application is for only the position indicated in the heading and that Brescia University will not consider this application as active for any other vacancy. I further understand that in no event will this application be considered an active application after 60 days from the date of my signature. By signing below, I certify that I have read, fully understand and accept all the statements above.

Consent

I agree to the applicant's agreement and certification

Name

First Last

Resume

Max. file size: 50 MB.