Supervisor Full time form - Palm Beach Uninversity

561-717-9969 [email protected]

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Supervisor Full time form

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Name

First Middle Last

Email(Required)

Phone Number(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employment status:*(Required)

To upload a file: 1. Click 'Browse...' and select the file from your computer. 2. Click 'Upload' to send the resume to us, this may take a few minutes depending on the speed of your internet connection. To delete a file that you have uploaded, click 'Delete'.

Please attach your Resume (CV)*(Required)

Accepted file types: jpg, png, pdf, docs, Max. file size: 100 MB.

jpg, png, pdf, docs

Please attach your Cover letter

Accepted file types: jpg, png, pdf, docs, Max. file size: 100 MB.

jpg, png, pdf, docs

Supporting Documents (e.g. Portfolio, letter of reference, etc.)

Accepted file types: jpg, png, pdf, docs, Max. file size: 100 MB.

jpg, png, pdf, docs

Supporting Documents (e.g. Portfolio, letter of reference, etc.)

Accepted file types: jpg, png, pdf, docs, Max. file size: 100 MB.

jpg, png, pdf, docs

Supporting Documents (e.g. Portfolio, letter of reference, etc.)

Accepted file types: jpg, png, pdf, docs, Max. file size: 100 MB.

jpg, png, pdf, docs

Are you 18 years or older?*(Required)

Are you legally authorized to work in the United States?*(Required)

Will you now, or in the future, require sponsorship in order to maintain authorization to work in the United States?*(Required)

YES

NO

What type of employment are you seeking? (Check all that apply)*(Required)

YES

NO

What date are you available to begin working?

Highest level of completed education:*(Required)

Do you want your application kept confidential?

YES

NO

External Applicants: Have you ever been employed at PBU before?

YES

NO

If yes, give exact dates and position held:

Reason for leaving PBU: (if applicable)

Please explain any gaps in your employment history:

Please detail your education below, starting from your highest level of education:

Highest level of education

Type of education:

Degree type:

Discipline:

Major:

Second major:

Additional majors:

Institution:

Education status:

Institution:

Education status:

Degree type:

Institution

Certificate type:

Education 2

Type of education:

Degree type:

Discipline:

Major:

Second major:

Additional majors:

Institution:

Education status:

Institution:

Education status:

Degree type:

Institution

Certificate type:

Education 3

Type of education:

Degree type:

Discipline:

Major:

Second major:

Additional majors:

Institution:

Education status:

Institution:

Education status:

Degree type:

Institution

Degree type:

Institution

Certificate type:

Please detail your employment experience below:

Employment status:*(Required)

Current/most recent employer

Employer

Position type:

Your responsibilities:

Date started with company:

Current/most recent employer

Employer

Position type:

Your responsibilities:

Date started with company:

Date ended with company:

Employer 2

Current/most recent employer

Employer

Position type:

Your responsibilities:

Date started with company:

Current/most recent employer

Employer

Position type:

Your responsibilities:

Date started with company:

Date ended with company:

Do you have a bachelor's degree?*(Required)

YES

NO

Reference 1

Type of referee:

Details

First name:*

Last name:*

Organisation:

Referee position:*

Phone Number:*

E-mail address:*

Reference 2

Type of referee:

Details

First name:*

Last name:*

Organisation:

Referee position:*

Phone Number:*

E-mail address:*

Reference 3

Type of referee:

Details

First name:*

Last name:*

Organisation:

Referee position:*

Phone Number:*

E-mail address:*

Have you ever pled guilty or "no contest" to a crime, been convicted of a crime, had adjudication withheld and/or prosecution deferred?*(Required)

If yes, please provide details. NOTE: Answering yes to this question does not constitute an automatic bar to employment. Only those crimes which are relevant to the position you are seeking will be considered.*(Required)

If yes, please provide details. NOTE: Answering yes to this question does not constitute an automatic bar to employment. Only those crimes which are relevant to the position you are seeking will be considered.*(Required)

Are you the subject of any investigation or proceeding that could result in your exclusion from participating for any length of time in any state or federally funded government health care program, including but not limited to Medicare and/or Medicaid?*(Required)

YES

NO

Not applicable

If you answered "Yes" to the question above, please explain the nature of exclusion in detail:

As part of our commitment to equal employment opportunity efforts, our institution conducts a survey of all job applicants. Submission of this information is entirely voluntary, and its contents are confidential to Human Resources. We do, however, appreciate your assistance and ask that you complete the following section. You may choose to "Not Disclosed" if you do not wish to provide the information.

Gender

Are you Hispanic or Latino?

Race Category Please mark the box(es) that describe the race/ethnicity category with which you identify (mark all that apply)

American Indian or Alaska Native

Black or African American

White

Asian

Native Hawaiian or Other Pacific Islander

Not Disclosed

Voluntary Self Identification of Protected Veteran Status(Required)

This employer is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. § 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows: A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service‐connected disability. A "recently separated veteran" means any veteran during the three‐year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. Protected veterans may have additional rights under USERRA—the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor's Veterans Employment and Training Service (VETS), toll‐free, at 1‐866‐4‐USA‐DOL. If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a Government contractor subject to VEVRAA, we request this info

I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERAN LISTED ABOVE

I AM NOT A PROTECTED VETERAN

I CHOOSE NOT TO SELF‐IDENTIFY

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. (i) To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to: · Blindness · Autism · Bipolar disorder · Post-traumatic stress disorder (PTSD) · Deafness · Cerebral palsy · Major depression · Obsessive compulsive disorder · Cancer · HIV/AIDS · Multiple sclerosis (MS) · Impairments requiring the use of a wheelchair · Diabetes · Epilepsy · Schizophrenia · Muscular dystrophy

Please check one of the boxes below:*(Required)

YES, I HAVE A DISABILITY (or previously had a disability)

NO, I DON'T HAVE A DISABILITY

I DON’T WISH TO ANSWER

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment. (i) Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp. PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Agreement(Required)

Agreement

The facts set forth in my application for employment are true and complete. I understand that, if employed, any false or misleading statement on this application may result in my dismissal. I further understand and agree that, if hired, my employment is "at will" and may be terminated at any time without cause and without prior notice. I understand the above information and permission is hereby given to make any necessary inquiries. I voluntarily and knowingly authorize any former employer, person, firm, corporation, school or government agency, its officers, employees, and agents to release any and all information concerning my former employment to NSU, its officers, employees, and agents or any other person or entity making a written or oral request for such information on behalf of NSU, its attorneys or insurance carriers. I understand that the employment information may include, but is not limited to, performance evaluations and reports, job descriptions, disciplinary reports, letters of reprimand and opinions in my suitability for employment possessed by it. I understand, that I am required to abide by all policies, rules and regulations of NSU. I agree, as a condition of hire, to provide all documents establishing proof of identity and employment eligibility in compliance with the Immigration Reform and Control Act of 1986. I further understand that certain positions may require that I be subject to drug testing, credit check, reference checks, and/or background screening including fingerprinting. BY SUBMITTING this application, I certify that I have read and agree with these statements.*

I agree

Phone

This field is for validation purposes and should be left unchanged.

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