University of Wisconsin-Madison s2
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University of Wisconsin-Madison APPLICATION FOR EMPLOYMENT AN EQUAL OPPORTUNITY EMPLOYER Classified LTE and Project Position Functioning under an Please complete all sections of this application Affirmative Action Plan
TITLE OF POSITION FOR WHICH YOU ARE APPLYING
NAME______(First) (Middle) (Last)
ADDRESS______Telephone (Work)______(Home)______No. & St. City Zip Code
SOCIAL SECURITY NUMBER______WISCONSIN RESIDENT? YES_____ NO_____
TYPE OF EMPLOYMENT YOU ARE SEEKING IF PART TIME, MINIMUM HOURS PER WEEK______MAXIMUM HOURS PER WEEK______(Check all types you will accept)
PROJECT_____ LIMITED TERM_____ FULL-TIME_____ PART-TIME_____ WEEKENDS_____ ROTATING SHIFTS_____
Day Shift (7:45-4:30)______Night Shift (11:00 pm-7:30 am)______Evening Shift (3:00 pm-11:30 pm)______
Education School Attended Location From To Graduation Date Course Major Degree Earned
High School ______xxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxx
Vocational School ______
Business College ______
College ______
Graduate School
Describe any education, training, or other experience you have had which is not covered above, such as correspondence course, military service, on the job training, apprenticeships, volunteer work, fluency in a foreign language, accounting, etc. Give dates. List any current licenses or registration as a member of a trade or profession.
The following information MUST be provided if you are applying for a position requiring typing or shorthand skills. Words Per Minute: Typing______Shorthand______
Do you have word processing experience? Yes_____ No_____ Do you have experience with personal computers? Yes_____ No_____
If yes, what kind of equipment/software (e.g. OfficeWriter, Lotus, Microsoft, etc)
List other office machines other than a typewriter which you can operate skillfully: WORK EXPERIENCES – PROVIDE A COMPLETE DESCRIPTION OF ALL QUALIFYING EXPERIENCE Start with your present or most recent job, include service in the armed forces and any self-employment. Indicate any change in job title under the same employer as a separate position.
PRESENT OR MOST RECENT EMPLOYER TYPE OF BUSINESS YOUR TITLE
FROM (MM/YY) TO (MM/YY) REASON FOR LEAVING OR CONSIDERING LEAVING AVERAGE HOURS PER WEEK
DESCRIPTION OF DUTIES Name, address & telephone of reference
PRESENT OR MOST RECENT EMPLOYER TYPE OF BUSINESS YOUR TITLE
FROM (MM/YY) TO (MM/YY) REASON FOR LEAVING OR CONSIDERING LEAVING AVERAGE HOURS PER WEEK
DESCRIPTION OF DUTIES Name, address & telephone of reference
PRESENT OR MOST RECENT EMPLOYER TYPE OF BUSINESS YOUR TITLE
FROM (MM/YY) TO (MM/YY) REASON FOR LEAVING OR CONSIDERING LEAVING AVERAGE HOURS PER WEEK
DESCRIPTION OF DUTIES Name, address & telephone of reference
May we contact employers for reference? Yes_____ No_____
I UNDERSTAND THAT ALL OF THE INFORMATION ON THIS APPLICATION IS TRUE AND COMPLETE, AND THAT ANY FALSE OR MISSING JOB RELATED INFORMATION MAY DISQUALIFY ME FOR THIS POSITION.
SIGNATURE______DATE______