Clark University Employment Application Form – Fill Out and Use This PDF

EDUCATION

PROFESSIONAL/VOCATIONAL LICENSE(S) AND EXPIRATION DATES:

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OTHER EDUCATIONAL AND TRAINING QUALIFICATIONS

(PLEASE INCLUDE FOREIGN LANGUAGE(S) YOU CAN SPEAK AND YOUR SKILL LEVEL)

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PLEASE CHECK EQUIPMENT OPERATED AND INDICATE YOUR SKILL LEVEL WHERE APPROPRIATE

HISTORY OF EMPLOYMENT AND WORK EXPERIENCE

PLEASE INDICATE MOST RECENT EXPERIENCE FIRST INCLUDING U.S. MILITARY SERVICE. THIS SECTION MUST BE COMPLETED IN ITS’

ENTIRETY, EVEN IF YOU ARE ATTACHING A RESUME.

IF THE LAST THREE EMPLOYERS DOES NOT COVER (10) YEARS OF EMPLOYMENT OR YOU NEED ADDITIONAL SPACE, PLEASE REQUEST AN ADDENDUM FORM TO ATTACH TO YOUR APPLICATION. PLEASE CHECK THIS BOX IF YOU HAVE ATTACHED A RESUME OR ADDENDUM.

RESUME/ADDENDUM ATTACHED

CAREER AND PROFESSIONAL ORGANIZATION MEMBERSHIPS

Please list JOB RELATED organizations, including clubs, professional societies, or other associations to which you currently belong. Please omit those that indicate your race, religion, color, national origin, ancestry, gender, marital status, disability, age or military affiliation.

PLEASE LIST THREE PROFESSIONAL REFERENCES

APPLICANT’S ACKNOWLEDGEMENT

(Please read and sign)

I acknowledge that an Employer paid Background Investigation and/or Substance Abuse Test is required for all positions at the University. I certify that answers given herein are true and complete to the best of my knowledge. I authorize an investigation of all statements contained in this application for employment, from either current or former employers and a verification of my education degree, training certificate, or license. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false, misleading, or misrepresentation of information given in my application or interview(s) may result in immediate discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Signature of Applicant: ____________________________________________________ Date: ______________________

CLARK ATLANTA UNIVERSITY IS AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER

It is the policy of the University that all faculty and staff employees and applicants receive equal consideration and treatment. All recruitment, hiring, placements, transfers, promotions will be on the basis of qualifications of the individual for the position being filled regardless of race, color, religion, national origin, ancestry, age, sex, martial status, pregnancy, medical condition, non-disqualifying disability or handicap, or whether the individual is a Disabled Veteran of the Vietnam Era. All other terms of employment are governed by this policy.

Revised 08/02