Staff Employment Application

Thank you for considering Manchester College in your career plans! To make the best match between your skills and experience with our requirements, we need a clear and accurate understanding of your background. Please complete all sections of this employment application and provide full information, even if you are including a résumé, which may be electronically submitted below. If a request for information is not applicable, type NA in the space provided.

Manchester College is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, religion, gender, marital status, sexual orientation, veteran status, disability or age.

Notice: All applicants for employment who receive an offer of employment may be required to submit to substance abuse testing and/or criminal background checks.

Click here to download a printable version of the application.

Personal Information
First name *	Middle name		Last name *
Preferred name		Other names under which you have worked or attended school:
Street address *		Email Address *
City *	State Outside USA Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming		Zip/postal code *
Home phone *	Office phone		Cell phone

Are you legally eligible to work in the U.S.? *	YesNo
Will you now or in the future require sponsorship for employment visa status (e.g., H-1B visa status)?	YesNo
Have you ever been convicted of a crime? * (This information will not necessarily prohibit your employment by the College.)	YesNo
Have you ever worked for Manchester College? *	YesNo
If yes, provide dates and title(s).
Are any members of your family or household currently employed by Manchester College? *	YesNo
If yes, please list.

Work Preference
Position for which you are applying *
Availability:	Full time Part time Temporary Week days Weekends Evenings/Nights

Where did you hear about this position?	Newspaper	specify:
	www.manchester.edu
	Agency	specify:
	Employee referral	name:
	Other source	specify:

Employment Data Please fill out this section completely. Do not indicate "refer to résumé." List all current and former employers for the past 10 years, beginning with the most recent employer. Include military service and self-employment.
Are you including a résumé as part of your application? *	YesNo
Are you currently employed? *	YesNo
If yes, may we contact your current employer?	YesNo

Employer 1
Employer	Employer's phone	Dates employed -
Address
City	State Outside USA Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip/postal code

Full name while employed (if different)
Job title	Job duties
Immediate supervisor	Supervisor's phone (including area code)
Starting annual/hourly compensation	Ending annual/hourly compensation
Full or part time	Full timePart time
Did you voluntarily end your employment?	YesNo
Please explain your reason for leaving.

Employer 2
Employer	Employer's phone	Dates employed -
Address
City	State Outside USA Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip/postal code

Full name while employed (if different)
Job title	Job duties
Immediate supervisor	Supervisor's phone (including area code)
Starting annual/hourly compensation	Ending annual/hourly compensation
Full or part time	Full timePart time
Did you voluntarily end your employment?	YesNo
Please explain your reason for leaving.

Employer 3
Employer	Employer's phone	Dates employed -
Address
City	State Outside USA Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip/postal code

Full name while employed (if different)
Job title	Job duties
Immediate supervisor	Supervisor's phone (including area code)
Starting annual/hourly compensation	Ending annual/hourly compensation
Full or part time	Full timePart time
Did you voluntarily end your employment?	YesNo
Please explain your reason for leaving.

Employer 4
Employer	Employer's phone	Dates employed -
Address
City	State Outside USA Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip/postal code

Full name while employed (if different)
Job title	Job duties
Immediate supervisor	Supervisor's phone (including area code)
Starting annual/hourly compensation	Ending annual/hourly compensation
Full or part time	Full timePart time
Did you voluntarily end your employment?	YesNo
Please explain your reason for leaving.

References
List only those we may contact at this time. References should be persons who can speak to your work performance.
Name	Name	Name
Company *	Company *	Company *
Title *	Title *	Title *
Phone *	Phone *	Phone *

Educational Background
High school attended	Years completed1234	Diploma or degree received
College or other education	Years completed1234	Diploma or degree receivedCourse or Major
College or other education	Years completed1234	Diploma or degree receivedCourse or Major

List special training, certificates and licenses
List your job-related knowledge and skills
List specific software (for example, Microsoft Word or Excel) in which you are proficient
List other skills that you feel would be useful in the position for which you are applying (for example, a second language)

Attached Documents
Please attach your documents if available and then proceed to the authorization and form submission area below.
Cover letter
Résumé/CV
Additional document
Additional document
Additional document
Additional document
Additional document
Additional document

Agreement, Authorization and Release *

By checking the box below and submitting this application, I agree to these terms and conditions. I certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand and agree that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. I authorize Manchester College and/or its agents to investigate my references, work record (except current employer, if marked "no"), education, criminal record and other matters related to my suitability for employment, including, but not limited to, my job performance and attendance records. Further, I authorize my former employers to disclose to the College any and all information related to my work record, without giving me prior notice of such disclosure. In addition, I hereby release the College, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities in any way related to such investigation or disclosure. I understand that, if hired, I will be required to provide approved documentation that verifies my right to work in the United States. I understand that nothing contained in the application or conveyed during any interview is intended to create an employment contract between the College and me. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either me or the College, and that no promises or representations contrary to the foregoing are binding on the College unless made in writing and signed by the College's president and me. I understand and agree that if employed by Manchester College, I will comply with all Manchester College policies and regulations, and if required, sign confidentiality and/or conflict of interest documents provided by the College.

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