Secondary: Name of School City and State Dates Attended Date of Graduation

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1 Employment Application for Faculty & Professional Positions 5735 College Parkway Mobile, AL Position: Date: I. PERSONAL INFORMATION Name: Address: Home Phone: Last First Middle Office Phone: Permanent Address: Place of Birth: Date of Birth*: Social Security Number: Marital Status: οmarried οsingle οdivorced οseparated οwidowed Children: Ages: Parent(s) Name(s): Parent(s) Address: Spouse s Name: Office Phone: Denominational Church Affiliation: Church Leadership Role(s): II. EDUCATION Secondary: Name of School City and State Dates Attended Date of Graduation Undergraduate: Name of College/University Dates Attended Credits Major Subject Minor Subject Degree: College: Date: Graduate Or Professional Study: Name of College/University Dates Attended Credits Major Subject Minor Subject * The Age Discrimination Act Prohibits Discrimination Against Persons At Least Forty Years of Age. PAGE 1

2 Master s Thesis: College: Date: Thesis Title: Where Available: Doctoral Degree: University: Date: Dissertation Title: Mss: Printed: Abstract: Date: Publisher: Where Available: Scholastic Honors (prizes, honorary societies, fellowships, grants, etc.) Language Attainments Reading Knowledge Speaking Knowledge Language Good Fair Poor Good Fair Poor French German Spanish Latin Greek III. EMPLOYMENT HISTORY Academic Teaching Institution Rank Dates Subjects Taught Academic Administration Institution Position Dates Other Experience Present Salary: Minimum Salary Requirements: PAGE 2

3 IV. MEMBERSHIP IN LEARNED OR PROFESSIONAL SOCIETIES Name of Society Office(s) Held Date of Entrance V. PUBLICATIONS (PLEASE INCLUDE TITLE, PUBLISHER AND DATE) VI. RESEARCH ACHIEVEMENTS VII. REFERENCES (PROVIDE AT LEAST FIVE, INCLUDING YOUR MINISTER) 1. Phone: 2. Phone: 3. Phone: 4. Phone: 5. Phone: VIII. PUBLIC SERVICE AND COMMUNITY INTERESTS IX. INSTITUTION WHERE CREDENTIALS ARE ON FILE X. REMARKS PAGE 3

4 XI. PLEASE EXPLAIN WHY YOU CHOSE TO APPLY FOR A POSITION AT THE UNIVERSITY OF MOBILE. Your Application For Employment At The University Of Mobile Will Be Considered Upon Receipt Of Your Completed Application And Vitae/Resume. Three Letters Of Reference And Official Transcript(s) Must Be Received Within Twenty-One (21) Days Of The Application Date. Please Mail Your Letters Of Reference And Official Transcripts To: University Of Mobile, Office Of Human Resources, 5735 College Parkway, Mobile, Alabama Selection, Placement, And Promotion Of Employees Shall Be Made Justly And Fairly On The Basis Of The Most Qualified As Determined By The University Of Mobile Administration Without Regard To Race, Color, National Origin, or Marital Status. Sex, Age, And Physical Condition Will Be Considered Only When Necessary To Meet The Demands Of Specific Job Qualifications. The University Of Mobile Is A Christian Institution Of Liberal Arts And Sciences Affiliated With The Alabama Baptist State Convention That Is Committed To Providing Educational Programs Of The Highest Quality To Its Students. Its Primary Emphasis Is Establishing And Maintaining A Tradition Of Excellence In Undergraduate Studies, As Well As In Professional, Graduate, Continuing Education, And Specialized Degree-Granting Programs. Whereas Research Is Encouraged, All Educational Programs Of The University Of Mobile Are Student-Oriented, Designed For The Intellectual, Spiritual, Cultural, And Personal Growth of Students In Their Search For Meaningful Careers And In Their Future Lives As Responsible, Informed Members Of A Global Society. As A Christian Institution, The University Of Mobile Explicitly Seeks To Combine A Critical Pursuit of Knowledge With Cultivation of Religious Awareness And To Unite Academic Excellence With Dedication To Service At The Local, State, National, and International Levels. All Employees Are Expected To Uphold, Support, And Contribute To The University Of Mobile's Commitment To Christian Higher Education. PAGE 4

5 PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize and agree to cooperate in a thorough investigation of all statements made herein and other matters relating to my background and qualifications. I understand that any investigation conducted may include a request for employment and educational history, credit reports, consumer reports, investigative consumer reports, driving record, and criminal history. I authorize any person, school, current and former employer, consumer reporting agency, and any other organization, or agency to provide information relevant to such investigation and I hereby release all persons and corporations requesting or supplying information pursuant to such investigation from all liability or responsibility to me for doing so. I understand that I have the right to make a written request within a reasonable period of time for complete disclosure of the nature and scope of any investigation. I further authorize any physician or hospital to release any information which may be necessary to determine my ability to perform the job for which I am being considered or any future job in the event I am hired. I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre-and/or post-employment drug screening as a condition of being hired or of my continued employment, if required. I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE. I have read, understand, and by my signature consent to these statements. Signature Date PAGE 5