Application - Extra Labor

Arkansas Tech University considers applicants for all positions without regard to race, color, age, marital or veteran status, the presence of non-job related mental condition or handicap, or any other legally protected status. Arkansas Tech University only accepts applications for vacant positions. An application must be completed for each position you are applying for. Only completed applications with work history will be accepted. The work history section of the application must be completed. We do not accept resume in lieu of completing this section. DO NOT HIT THE ENTER KEY UNTIL YOU HAVE COMPLETED THE APPLICATION.

Please don't fill out this input box.

Personal

Last Name:

First Name:

Middle Name:

Email:

Street Address:

City:

State:

ZIP:

Home Phone:

Business Phone:

Position Applying for:*

Expected Salary:

When are you able to begin work?

Have you ever been employed by ATU?

Yes

Year:

Department:

List your skills, training, licenses, or certificates significant to the position:

Education

Include your education background.

College

Name & Location:

Major:

Years Completed:

Graduation Date:

Degree or Diploma:

Business, Trade or Technical School

Name & Location:

Major:

Years Completed:

Graduation Date:

Degree or Diploma:

Highschool

Name & Location:

Years Completed:

Graduation Date:

Employment

Please give accurate, complete full-time and part-time employment record. Start with your present or more recent employer.

Employer 1

Company Name:

Address:

Phone:

Name of Supervisor:

Employed From:

Employed To:

Salary Beginning:

Salary Ending:

Job Title & Duties:

Reason for Leaving

Employer 2

Company Name:

Address:

Phone:

Name of Supervisor:

Employed From:

Employed To:

Salary Beginning:

Salary Ending:

Job Title & Duties:

Reason for Leaving:

Employer 3

Company Name:

Address:

Phone:

Name of Supervisor:

Employed From:

Employed To:

Salary Beginning:

Salary Ending:

Job Title & Duties:

Reason for Leaving:

Employer 4

Company Name:

Address:

Phone:

Name of Supervisor:

Employed From:

Employed To:

Salary Beginning:

Salary Ending:

Job Title & Duties:

Reason for Leaving:

We may contact the employers listed above unless you indicate below those you do not want us to contact.

Employer Number:

Reason:

Employer Number:

Reason:

References

Include at least one character and one technical reference excluding relatives.

Reference 1

Name:

Address:

Phone:

Business/Occupation

Reference 2

Name:

Address:

Phone:

Business/Occupation:

Reference 3

Name:

Address:

Phone:

Business/Occupation:

The information in this application for Employment is true, correct, and complete.
If employed, any misstatement or omission of fact on this application may result in dismissal.

Arkansas Tech University is an Equal Opportunity Employer. It is a policy of this University not to discriminate on the basis of race, color, creed, sex, national origin, age, mental or physical disability of applicants. This is in compliance with all Federal, State, and Local statutes, ordinances, and regulations.