Staff Employment Application | Human Resources | Southern Arkansas University

Please answer all questions which apply to you. If they do not apply, mark them N/A. Please type or write legibly.

Name*
First Last
Complete mailing address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Enter Email Confirm Email
Phone*
Message or other Phone Number
- Applications for employment with Southern Arkansas University, Magnolia, or any subdivision thereof, are accepted without regard to sex, race, color, national origin, disability, age, religion, or political affiliation. Conviction of a crime does not automatically bar any applicant from employment or other opportunities with SAU
- Applications, once filed, may be subject to disclosure as a public record under the Arkansas Freedom of Information Act.
- Applications filed do not create a contract of employment with SAU or any of its subdivisions. If any individual is hired, employment is for no definite period of time. Individuals hired will also be required to provide proof of eligibility to work in the United States pursuant to the Immigration Reform and Control Act of 1986.
- Qualified applicants with disabilities, as defined in the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, may request any needed accomodations to participate in the application process.
Position*
Applications can only be accepted for advertised positions. Please list the positions for which you are applying:
Have you ever filed an application for employment with SAU?
- Yes
- No
If yes, what was your name at that time if different from above?
Have you ever been employed by Arkansas State Government?
- Yes
- No
List professional license(s) relevant to positions for which you are applying. Give type of license, license number, date of expiration, and state.
May we contact your current employer?
- Yes
- No
May we contact your former employer(s)?
- Yes
- No
Work History
List all prior work experience, including military service, beginning with your most recent employment. You may include volunteer or unpaid work as part of your history; however, you should include the number of hours per week that you performed these duties. If you do not have enough space to list all your work experience, use a separate sheet for continuation. If you wish to include a resume instead of completing the work history section, make sure all the requested information is included.
Current or most recent employer
Current or most recent employer's name
Business phone number
Complete mailing address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of business
Supervisor's name
Name under which employed
Your job title
Your job duties (be specific)
Employment start date (month/year)
Employment end date (month/year)
Average hours worked per week
Lowest salary
Highest salary
Reason for leaving
2nd Employer
Employer's name
Business phone number
Complete mailing address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of business
Supervisor's name
Name under which employed
Your job title
Your job duties (be specific)
Employment start date (month/year)
Employment end date (month/year)
Average hours worked per week
Lowest salary
Highest salary
Reason for leaving
3rd Employer
Employer's name
Business phone number
Complete mailing address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of business
Supervisor's name
Name under which employed
Your job title
Your job duties (be specific)
Employment start date (month/year)
Employment end date (month/year)
Average hours worked per week
Lowest salary
Highest salary
Reason for leaving
4th Employer
Employer's name
Business phone number
Complete mailing address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of business
Supervisor's name
Name under which employed
Your job title
Your job duties (be specific)
Employment start date (month/year)
Employment end date (month/year)
Average hours worked per week
Lowest salary
Highest salary
Reason for leaving
5th Employer
Employer's name
Business phone number
Complete mailing address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of business
Supervisor's name
Name under which employed
Your job title
Your job duties (be specific)
Employment start date (month/year)
Employment end date (month/year)
Average hours worked per week
Lowest salary
Highest salary
Reason for leaving
Educational History
High School- Received:
- Diploma
- G.E.D.
- Certificate
- None
Certificate type awarded:
If none, highest grade completed:
Have you attended any post secondary schools, colleges, universities, or trade/vocational schools?
- Yes
- No
Name of school
Location of school
Attended from:
month/year
To:
month/year
Major/minor
Hours completed:
Indicate what kind of hours (semester, quarter, clock, etc.)
Degree/Diploma Awarded
Date graduated
Do you have a 2nd institution to add?
- Yes
- No
Name of school
Location of school
Attended from:
month/year
To:
month/year
Major/minor
Hours completed:
Indicate what kind of hours (semester, quarter, clock, etc.)
Degree/Diploma Awarded
Date graduated
Do you have a 3rd institution to add?
- Yes
- No
Name of school
Location of school
Attended from:
month/year
To:
month/year
Major/minor
Hours completed:
Indicate what kind of hours (semester, quarter, clock, etc.)
Degree/Diploma Awarded
Date graduated
Do you have a 4th institution to add?
- Yes
- No
Name of school
Location of school
Attended from:
month/year
To:
month/year
Major/minor
Hours completed:
Indicate what kind of hours (semester, quarter, clock, etc.)
Degree/Diploma Awarded
Date graduated
List the business machines, computers, and software programs you can operate:
List any other skills relative to the job(s) for which you are applying:
References
Please list three (3) references who are not related to you, and who have knowledge of your work qualifications.
Reference #1 Name
First Last
Reference #1 Phone
Reference #1 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference #2 Name
First Last
Reference #2 Phone
Reference #2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference #3 Name
First Last
Reference #3 Phone
Reference #3 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Nepotism
Do you have any relatives who are employed by SAU?
- Yes
- No
If yes, then list them below: (This question is being asked for the sole purpose of ensuring compliance with any applicable law or policy concerning nepotism.)
Resume upload
Max. file size: 6 MB.
Please check whether or not a resume is needed to complete your application. Maximum file size is 6MB.
Cover letter upload
Max. file size: 6 MB.
Please check whether or not a cover letter is needed to complete your application. Maximum file size is 6MB.
Reference letters
Max. file size: 6 MB.
(Optional) Maximum file size is 6MB.
Before you submit this application
Please read carefully. By submitting this application you are acknowledging that you have read and understand the statements below.
- Check your answers to make sure that all questions have been completed properly. If the job you are applying for requires a college degree or certification, a copy of your transcript, certificate, or license may be required as a condition of employment.
- I hereby declare that to the best of my knowledge and my ability, the information on this application is true and factual.
- I understand that if I am hired, that my employment is for no definite period of time, and I may be terminated at any time.
- I understand that if I state that I have a college degree, and do not have one, that my application will be rejected or, if hired, I will be terminated in accordance with Arkansas Statute 21-12-102.
- I understand that my application may be subject to disclosure as a public record under the Arkansas Freedom of Information Act.
- I understand that certain jobs may require an acceptable driver’s safety record, and that if my current or future driver’s record is unacceptable under that State Driver’s Risk Program, my application may be rejected and, if hired, I may be subject to termination.
- I understand that I will be required to provide proof of eligibility to work in the United States pursuant to the Immigration Reform and Control Act of 1986 as a condition of employment.
- I understand that false, misleading, or incomplete statements on this application are grounds for immediate dismissal as an employee or rejection as an applicant.
- I also understand that all jobs are subject to criminal and other background checks prior to my employment, or as a condition of employment; and that failure to meet these requirements may lead to my rejection as an applicant for, or termination from, that job.
Please type your full name again to "sign" that you have read the statements above.
Equal Employment Data
This section is designed to collect information which will be used in the completion of various state and federal reports and will not be used in the processing of, or remain part of your application. The completion of this section is voluntary.
Applicant's name
Date of birth
MM slash DD slash YYYY
Select one:
- Male
- Female
Check one of the five (5) listed which you consider yourself to be:
- White, not Hispanic (A person having origin in any of the original peoples of Europe, North Africa, or the Middle East.)
- Black, not Hispanic (A person having origin in any of the black racial groups in Africa.)
- Hispanic (A person of Mexican, Puerto Rican, Cuban, Central or South American or Spanish Culture or origin, regardless of race.)
- American Indian or Alaskan Native (A person having origin in any of the original people of North America, and who maintains cultural identification through tribal affiliation or community recognition.)
- Asian or Pacific Islander (A person having origin in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands.)
Military History
If you believe you may be eligible for veterans preference consideration, complete this section. The Arkansas Veterans Preference Act states specific requirements which must be met in order to be eligible for veterans preference. Under certain conditions, spouses, widows, or widowers of qualified veterans may also be eligible for veterans preference. For consideration of veterans preference, proof such as a DD-214, current letter from the Veterans Administration, or other official documentation may be required. Specific questions regarding veterans preference should be addressed to individual state agency personnel offices.
Have you served on active duty in the United States military, excluding Active Duty for Training (AcDuTra) and Reserve Military Annual Training (AT)?
- Yes
- No
Branch of service
Date of entry
Date of discharge
Type of discharge
How did you learn of this job opening?
- Newspaper
- Employment Security Division
- SAU Web site
- Educational Institution
- Other
Name of institution
If other, please explain

Work History

Current or most recent employer

2nd Employer

3rd Employer

4th Employer

5th Employer

Educational History

References

Nepotism

Before you submit this application

Equal Employment Data

Military History

Schools & Colleges

Quick Links

Social