MISSOURI WESTERN STATE UNIVERSITY
Application for Employment
Today’s Date:
POSITION APPLYING FOR: 
You must fill out all sections of this application completely and honestly. This information will be used to determine your eligibility for this position. All application materials become the property of Missouri Western State University and will not be returned. You must meet all of the minimum qualifications for the position(s) you are applying for in order to be considered.
PERSONAL INFORMATION
*Name (Last, First, Middle Initial):
*Address (Street, City, State, Zip Code):
*Telephone Number:
 Work Phone Number:
 May we contact you at work?
Yes    No
*Email Address:
*Are you now or have you been employed by Missouri Western State University? Yes    No
If Yes, list dates and department(s):
*Are you related to anyone currently employed by Missouri Western State University OR now serving on the Board of Governors?
Yes    No
If Yes, list name and relationship:
*How did you find out about this job opening?
MWSU Website      Human Resources Office      University Employee
Newspaper (Identify)       Other
*Are you authorized to work in the U.S.? Yes    No
If employed, you must show documents that prove your identity and employment eligibility as required by the Immigration Reform and Control Act of 1986.
*Have you ever been convicted of a crime other than a minor traffic violation? Yes, please explain below     No
(Disclosure of a criminal record will not necessarily disqualify you from employment consideration. Each offense will be evaluated on its own with respect to time, circumstance and seriousness in relationship to the job in which you are applying).
EDUCATION & SKILLS
Please list all education. Indicate a diploma or degree, if completed, including GED if obtained.
Select Highest Grade Completed:
High School
9 10 11 12		 Vocational/Trade School
1 2		 College/University
1 2 3 4 5 6
High School:  Did you graduate? Yes No
Address:
College/University:   Did you graduate? Yes No

Diploma or Degree:

Address:
Other Course of Study Name:    Did you graduate? Yes No
Diploma or Degree:
Address:
OFFICE/COMPUTER SKILLS
Please check all boxes that apply and then indicate the number of years experience and/or any relevant training completed.
Microsoft Word Power Point Typing wpm
Excel SCT/Banner E-mail Applications
Missouri Public Safety Department P.O.S.T. Certified (Public Safety Only)  
List technical or specialized skills/credentials relevant to this job, including certifications, professional licenses, and knowledge of other computer software not listed above.
EMPLOYMENT HISTORY
List ALL relevant employment starting with the most current position held, including any volunteer experience or experience obtained in military service. Please explain gaps in employment history. You may attach a resume, but you must complete the employment section. This information will be used in reference checks. Failure to answer all items in the following section may eliminate you from further consideration.
Dates Employed (month/year):
From:   To: 		Position Title:
Salary:
Start:   Final: 		Organization Name/Address:
Full-time Part-time, hrs/wk Reason For Leaving:
Supervisor's Name/Title/Phone:
 May we contact for references?
Yes   No
Duties:
Dates Employed (month/year):
From:   To: 		Position Title:
Salary:
Start:   Final: 		Organization Name/Address:
Full-time Part-time, hrs/wk Reason For Leaving:
Supervisor's Name/Title/Phone:
 May we contact for references?
Yes   No
Duties:
Dates Employed (month/year):
From:   To: 		Position Title:
Salary:
Start:   Final: 		Organization Name/Address:
Full-time Part-time, hrs/wk Reason For Leaving:
Supervisor's Name/Title/Phone:
 May we contact for references?
Yes   No
Duties:
UPLOAD SUPPORTING DOCUMENTS
Please upload any supporting documents requested in the ad.








PLEASE READ CAREFULLY: I certify that all answers given in this application are complete and correct to the best of my knowledge. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand if I am employed as a non-exempt employee, I will be employed "at will", which means that either the University or the employee can terminate employment at any time. Nothing contained in this application form should be interpreted as a contract.
 

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NOTICE OF NONDISCRIMINATION - Per Title VI of the Civil Rights Act of 1964 ,Title IX of the Education Amendments of 1972, and Section 504 of the Rehabilitation Act of 1973, the University does not discriminate on the basis of race, color, religion, national origin, ancestry, sex, age, disability, or status as disabled veteran or veteran of the Vietnam Era. Any person having inquiries concerning Missouri Western State University compliance with these regulations is encouraged to contact the campus Equal Employment Opportunity Representative. INFORMATION AVAILABLE - MWSU makes available to applicants a security report of crimes that occurred on campus over the previous three years. For a copy of this report, contact the MWSU Police Department at 816-217-4438 or access their website at: http://www.missouriwestern.edu/safetyreport.
Last updated 06/05/17


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