Application For Employment

Mercy College treats all employees and applicants for employment without unlawful discrimination as to race, creed, color, national origin, sex, age, disability, marital status, sexual orientation, past, present, future service in the uniformed services, genetic carrier status or citizenship status in all employment decisions, including but not limited to recruitment, hiring, compensation, training and apprenticeship, promotion, upgrading, demotion, downgrading, transfer, lay-off and termination, and all other terms and condition of employment.

Mercy College employees must inform their manager before applying.

Position Desired:

Date: 07-Aug-08

Salary Required:

How Did You Learn About Us?
Advertisement Source: Friend Walk-In Employment Agency Relative Other

Last Name:
First Name :
Middle Name :

Street:
City:
State:
Zip:

Home Phone:
Business Phone:

If you are under 18 years of age, can you provide required proof of your eligibility to work? Yes No

Have you ever filed an application with us before?	Yes No
If Yes,give date:

Have you ever been employed with us before?	Yes No
If Yes,give date: From:		To:

Are you related by birth, marriage or co-habitation to any employee of Mercy College?	Yes No
If Yes, explain:

Are you currently employed?	Yes No

May we contact your present employer?	Yes No

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?
Proof of citizenship or immigration status will be required upon employment.	Yes No

On what date would you be available for work?	(MM/DD/YYYY)

Are you available to work: Full Time Part Time Temporary

Are you currently on "lay-off" status and subject to recall?	Yes No

Can you travel if a job requires it?	Yes No

Have you been convicted of a felony within the last 7 years?	Yes No
Conviction will not necessarily disqualify an applicant from employment.

If Yes, please explain:

EDUCATION:

School	Name/Address.	Major	Minor	Credits/Units	Degree/
	of School			Completed	Diploma

High School

Undergraduate College

Graduate Professional

Other (Specify)

Please write the language you speak, read or write, either fluently, good or fair in the corresponding space provided.

	FLUENT	GOOD	FAIR
SPEAK
READ
WRITE

Describe any specialized training, apprenticeship, skills and/or job related training received in the United States. Describe any community activities and non-employment organizational leadership experiences.

Specialized Skills:

Describe competence with business technology:

	None	Some	Proficient
Mac
PC
Lan/Wan
Desktop Publishing
Fax
Spreadsheet
Internet
Copy Machine
Word Processing
Scanner
Database

Other business skills:

Employment Experience

Start with your present or last job. Include any job related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employer:	Dates Employed		Work Performed
	From	To

Address:	Supervisor's Tel. #	Annual Salary/Rate
		Starting	Final

Applicant's Job Title:	Supervisor:	Reason for Leaving:

Employer:	Dates Employed		Work Performed
	From	To

Address:	Supervisor's Tel. #	Annual Salary/Rate
		Starting	Final

Applicant's Job Title:	Supervisor:	Reason for Leaving:

Employer:	Dates Employed		Work Performed
	From	To

Address:	Supervisor's Tel. #	Annual Salary/Rate
		Starting	Final

Applicant's Job Title:	Supervisor:	Reason for Leaving:

Additional Information

State any additional information you feel may be helpful to us in considering your application. You may list professional organizations/associations with which you are affiliated here. (You may opt not to list organizations/associations which will identify any protected class such as race, religion, ethnicity, etc.)

Professional References

1	Name:
	Title: (Applicant's Supervisor/Manager only)
	Phone #:
	Company:
	May we contact?	Yes No

2	Name:
	Title: (Applicant's Supervisor/Manager only)
	Phone #:
	Company:
	May we contact?	Yes No

3	Name:
	Title: (Applicant's Supervisor/Manager only)
	Phone #:
	Company:
	May we contact?	Yes No

4	Name:
	Title: (Applicant's Supervisor/Manager only)
	Phone #:
	Company:
	May we contact?	Yes No

Applicant's Statement

By submitting this electronic application, I certify that answers given herein 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.

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.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that 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 writing by an authorized executive of this organization.

I authorize Mercy College to obtain information about me from my previous employer(s), and school(s) attended. I also authorize my previous employer(s) and school(s) attended to disclose to Mercy College such information as may be requested about me including but not limited to copies of evaluations and transcripts, and any information regarding disciplinary actions and notations regarding performance issues. I further authorize Mercy College to conduct background checks including drug screening, credit and criminal background checks as may be necessary.

I release my former schools and employers from any liability associated with furnishing Mercy College information as specified above.

In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand, also, that I am required to abide by rules and regulations of the employer.

Copy and Paste your cover letter with salary requirement here (required):

Upload your resume here (required):