Secure Employment Application

Lakewood University is currently accepting creative and hard working applicants to fill a number of available positions. To ensure proper consideration, please fill in the information below as completely and accurately as possible.

Personal Information

Position Sought *

How did you learn about this position? *

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Postal Code *

Phone *

Office Phone

Email Address *

Social Security Number (Optional)

Are you authorized to work in the U.S. without any restriction? *

Have you ever been convicted of a felony? * 🛈

Yes

No

If yes, please explain.

Have you ever been involuntarily terminated or asked to resign from any position of employment? *

Yes

No

If yes, please explain.

If selected for employment, are you willing to submit to a pre-employment drug screening test? *

If selected for employment, are you willing to submit to a pre-employment medical test, if applicable? *

Education

	Please complete for each school attended
School Name	Please complete for each school attended
Location	Please complete for each school attended
Years attended	Please complete for each school attended
Degree Received	Please complete for each school attended
Major	Please complete for each school attended

Education

	Please complete for each school attended
School Name	Please complete for each school attended
Location	Please complete for each school attended
Years attended	Please complete for each school attended
Degree Received	Please complete for each school attended
Major	Please complete for each school attended

Education

	Please complete for each school attended
School Name	Please complete for each school attended
Location	Please complete for each school attended
Years attended	Please complete for each school attended
Degree Received	Please complete for each school attended
Major	Please complete for each school attended

Education

	Please complete for each school attended
School Name	Please complete for each school attended
Location	Please complete for each school attended
Years attended	Please complete for each school attended
Degree Received	Please complete for each school attended
Major	Please complete for each school attended

Other training, certifications, or licenses held:

List other information pertinent to the employment you are seeking:

Availability

Days Available *

Employment History

Employer 1 *

Address *

Phone *

From (MM/YYYY) *

To (MM/YYYY) *

Position *

Salary *

Supervisor/Manager *

Reason for Leaving *

Employer 2

Address

Phone

From (MM/YYYY)

To (MM/YYYY)

Position

Salary

Supervisor/Manager

Reason for Leaving

Employer 3 *

Address

Phone

From (MM/YYYY)

To (MM/YYYY)

Position

Salary

Supervisor/Manager

Reason for Leaving

References

Name

Title

Phone

Email Address

Name

Title

Phone

Email Address

Name

Title

Phone

Email Address

Additional Skills

Typing Speed (words per minute)

List any additional skills that you would like to mention.

Please submit a copy of your resume. *

ACKNOWLEDGEMENT AND AUTHORIZATION

PLEASE NOTE: this application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

Please check each statement below *

I certify that answers given here are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with Lakewood University is of an "at will" nature, which means 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 Lakewood University.

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

By typing my name below I am signing this application. *

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