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Directions:
1.
Complete the form below. (*Hint: Do Not press Enter while filling out the application. Use the tab key to move down to each new box while entering your information.)
2. To email this form press the
"E-Mail" button at the bottom of the page. The form
will then be emailed to the Human Resources office at WNMU
(Sally Beckworth and
Charlene Ashburn ) who
will process your form.
3. To print this form requires a printer. Once you have completed the form, and before you Email it, press Control P to bring up your printer. You can then print the completed form for your records or to mail it to WNMU.
4. Once we receive your application (either online or
by mail), we will send you correspondence pertaining to the position you have applied for. And, if you have questions at any point
during the process, do not hesitate to call (575-538-6328) or
email us at at beckworths@wnmu.edu or ashburnc@wnmu.edu.
5. Additional required documents as stated on the job announcement can be submitted via email to the addresses mentioned above, or faxed to 575-538-6338, or sent by regular mail to Western New Mexico University, Human Resources Department, 1000 W. College Ave./P.O. Box 680, Silver City, NM 88062.
Mailing Address: (Street/PO Box, City,State Zip)
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If necessary, best time to call you at home is:
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May we contact you at work?
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If yes, work number and best time
to call:
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Work Number:
Best time to call:
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If you are under 18, can you furnish a work permit?
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Have you ever been employed here before?
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If yes, give dates:
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Fromto
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Are you related to anyone currently working at this
university?
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If yes, who:
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And their department:
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Are you legally eligible for employment in this country?
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(Proof of US citizenship or immigration
status will be required upon employment.) All offers of
employment are conditional upon satisfactory proof of
identity and legal ability to work in the United States of
America.
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Date available for work:
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Type of employment desired:
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Are you on a lay-off and subject to recall?
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If required by the employer, will you undergo
pre-employment physical?
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Have you ever been bonded?
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An Equal Opportunity Employer
EMPLOYMENT HISTORY
List
your last four (4) employers, assignments, or volunteer
activities; starting with most recent, including military
experiences. Explain any gaps in employment in comment
section below. Please use additional paper if necessary.
Comments (including explanation of any gaps in
employment):
Skills and Qualifications
Summarize special skills
and qualifications acquired from employment or other
experiences that may qualify you for work with our
University.
EDUCATIONAL BACKGROUND
A. List
last three (3) schools attended, starting
with last one. B.
List number of years completed. C.
Indicate degree or diploma earned,
if any. D. Grade
Point Average or Class Rank. E.
Major and Minor field of study (if
applicable).
A. School
B.
No. of years completed
C.
Degree or Diploma
D.
GPA or Class Rank
E.
Major
and Minor
A. School
B.
No. of years completed
C.
Degree or Diploma
D.
GPA or Class Rank
E.
Major
and Minor
A. School
B.
No. of years completed
C.
Degree or Diploma
D.
GPA or Class Rank
E.
Major
and Minor
List any foreign language(s) and choose the
selection that best describes your skill.
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Language
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Skill
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REFERENCES
List name and telephone number of
five business/work references who are not related to you
and are not previous supervisors. If not applicable
please list three school or personal references who are not
related to you.
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Name
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Years Known
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Telephone
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Email address |
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Years Known
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Telephone
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Name
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Years Known
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Telephone
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Email address |
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Name
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Years Known
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Telephone
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Email address |
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Name
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Years Known
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Telephone
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List professional, trade, business
or civic associations and any offices held. (Exclude memberships
which would reveal sex, race, religion, national origin, age,
ancestry or other protected status.)
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ORGANIZATION
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OFFICES HELD
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List special accomplishments, publications and
awards. (Exclude information which would reveal sex, race,
religion, national origin, age, ancestry or other protected
status.)
List any additional information you would like
us to consider.
Please consider filling out the voluntary
affirmative action information survey. The information you
give will not affect your employment or be used in any selection
process. Fill out survey.
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We consider applications for
all positions without regard to race, color, religion, sex,
national origin, age, marital or veteran status, the
presence of a non-job-related medical condition or
disability, or any other legally protected status.
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The facts set forth in my application for employment are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of the facts contained in this application, including criminal convictions if legally relevant to my employment, through any investigative agencies or bureaus of your choice.
I understand that I have a right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of any such investigative reports that are made.
Clicking on the "E-Mail" button indicates you agree to the above statement and emails
the application to the Human Resources Office.
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