Manchester University Office of Human Resources Staff Application

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Staff Employment Application

Thank you for considering Manchester University 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 University 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.

Note: JavaScript must be enabled to submit this form.Please e-mail us if you have trouble with this restriction.

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		Zip/postal code *
Home phone *	Office phone		Cell phone

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? *	Yes No
Are you currently employed? *	Yes No
If yes, may we contact your current employer?	Yes No

Employer 1
Employer	Employer's phone	Dates employed -
Address
City	State	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 time Part time
Did you voluntarily end your employment?	Yes No
Please explain your reason for leaving.

Employer 2
Employer	Employer's phone	Dates employed -
Address
City	State	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 time Part time
Did you voluntarily end your employment?	Yes No
Please explain your reason for leaving.

Employer 3
Employer	Employer's phone	Dates employed -
Address
City	State	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 time Part time
Did you voluntarily end your employment?	Yes No
Please explain your reason for leaving.

Employer 4
Employer	Employer's phone	Dates employed -
Address
City	State	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 time Part time
Did you voluntarily end your employment?	Yes No
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 completed 1 2 3 4	Diploma or degree received

College or other education	Years completed 1 2 3 4	Diploma or degree received Course or Major

College or other education	Years completed 1 2 3 4	Diploma or degree received Course 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 University 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 University any and all information related to my work record, without giving me prior notice of such disclosure. In addition, I hereby release the University, 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 University 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 University, and that no promises or representations contrary to the foregoing are binding on the University unless made in writing and signed by the University's president and me. I understand and agree that if employed by Manchester University, I will comply with all Manchester University policies and regulations, and if required, sign confidentiality and/or conflict of interest documents provided by the University.

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 University 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 University any and all information related to my work record, without giving me prior notice of such disclosure. In addition, I hereby release the University, 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 University 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 University, and that no promises or representations contrary to the foregoing are binding on the University unless made in writing and signed by the University's president and me.

I understand and agree that if employed by Manchester University, I will comply with all Manchester University policies and regulations, and if required, sign confidentiality and/or conflict of interest documents provided by the University.

Manchester University is an Equal Opportunity Employer

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Are you legally eligible to work in the U.S.? *	Yes No
Will you now or in the future require sponsorship for employment visa status (e.g., H-1B visa status)?	Yes No
Have you ever been convicted of a crime? * (This information will not necessarily prohibit your employment by the University.)	Yes No
Have you ever worked for Manchester University? *	Yes No
If yes, provide dates and title(s).
Are any members of your family or household currently employed by Manchester University? *	Yes No
If yes, please list.

Staff Employment Application

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