Staff Employment Application
CALIFORNIA BAPTIST UNIVERSITY
8432 MAGNOLIA AVENUE
RIVERSIDE, CA 92504-3297
Telephone (951) 343-4334 Fax: (951) 343-4526

Distribution: This form, when completed, will be distributed to the necessary departments that are involved in the selection process.
Instructions: This form is to be filled out completely and accurately by the applicant.

NONDISCRIMINATION STATEMENT
State and Federal law permit California Baptist University to discriminate on the basis of religion in order to fulfill its purpose. The University does not discriminate contrary to either State or Federal law.

Please provide all information requested.
* = Required Field
POSITION
   
For what position are you applying? *
Application Date: 5/4/2016
    
How did you hear about the position?
 
 
   
What type of position do you want? *
   
When are you available to fill a position? *
   
Have you ever filed an application for any position with us before? *
   
Are you a citizen of the United States? *
   
If the answer to the preceding question was no, are you requesting that California Baptist University act as a sponsor for you in the United States for purposes of citizenship?
 
 
PERSONAL
 
Last Name: * First Name: * MI:  
E-mail address: *   
Number and Street Address: *
City: * State: * Zip: *
 Home Telephone: *  Business Telephone:  Other Telephone:
 
Person to notify in an emergency:
Last Name: First Name: MI: Telephone:
 
Month/Year
Have you ever been employed with us before? *  If yes, give date:
     
Have you ever been convicted of a felony? * 
 (Conviction will not necessarily disqualify an applicant from employment)
   
If you answered "yes" to the preceding question, please explain your answer:
 
 
EDUCATION BACKGROUND
 
Institution: Degree: Major/Minor Date of Completion:
   
   
   
   
   
       
 
SPECIAL QUALIFICATIONS, SKILLS, AND ABILITIES
 
Name of License
or Certificate
Registration Number Name of State Expiration Date Valid? Comments
 
Have you ever been a supervisor? * 
If yes, describe responsibilities:

 Check the appropriate box if you have the skill or ability to use the equipment:
WPM
 
Have you ever had any position-related training in the United States Military Services? * 
If yes, describe training:
 
Summarize other special position-related qualifications, skills, and abilities acquired from employment or other experience:
 
What languages do you... Speak:
Write:
Read:
 
Can you perform the essential function of the job for which you have applied with or without reasonable accommodation? *
 
If you do require reasonable accommodation, please specify in detail what the accommodation or accommodations would be:
 
 
EMPLOYMENT HISTORY
 
Please give an accurate and complete full-time and part-time employment history for the past 10 years. A resume may not be substituted. Include any position-related military service assignments and volunteer activities.
1. EMPLOYER (Present or Last)
May we contact?
 
Name of Employer: * Job Title:
Number and Street Address:
City: State: Zip:
Telephone: Name of Supervisor:
  Annual Salary:
   
From: (Month/Year) To: (Month/Year)
Describe work performed (Maximum characters 1,500):
Reason for Leaving:
 
 
2. EMPLOYER
May we contact?
 
Name of Employer: Job Title:
Number and Street Address:
City: State: Zip:
Telephone: Name of Supervisor:
  Annual Salary:
   
From: (Month/Year) To: (Month/Year)
Describe work performed (Maximum characters 1,500):
Reason for Leaving:
 
 
3. EMPLOYER
May we contact?
 
Name of Employer: Job Title:
Number and Street Address:
City: State: Zip:
Telephone: Name of Supervisor:
  Annual Salary:
   
From: (Month/Year) To: (Month/Year)
Describe work performed (Maximum characters 1,500):
Reason for Leaving:
 
 
4. EMPLOYER
May we contact?
 
Name of Employer: Job Title:
Number and Street Address:
City: State: Zip:
Telephone: Name of Supervisor:
  Annual Salary:
   
From: (Month/Year) To: (Month/Year)
Describe work performed (Maximum characters 1,500):
Reason for Leaving:
 
 

You may optionally choose to upload a copy of your resume: 
Your resume does not substitute for this application form. You must include all relevant information requested on this form.
 
CHRISTIAN EXPERIENCE
 
California Baptist University exists to provide liberal arts education of superior quality in a setting that is openly and positively Christian. Consequently, the University asks:
Are you a Christian? *
Are you a member of a church? *
If the answer to the preceding question is yes, what church?
Are you both familiar with and not in conflict with the fundamental doctrines and practices of the California Southern Baptist Convention as stated in the Baptist Faith and Message dated June 14, 2000?
(Click here to view the Baptist Faith and Message)
*