Staff Employment Online Application

Drury University Non-Discrimination Statement

Approved by Board of Trustees 5-16-14

Drury University is an open and welcoming community from a rich variety of cultures, races and socio-economic backgrounds.  The mission and goals of the university dedicate the institution to being a community which “affirms the quality and worth of all peoples” and appreciates the “diversity of human culture, language, history and experience.”

Drury University does not discriminate on the basis of disability, race, color, religion, gender, age, sexual orientation, national or ethnic origin, or veteran status in its programs and activities.  The following persons have been designated to handle inquiries regarding Drury’s non-discrimination policies:

Coordinator - Non-Discrimination / Harassment & Title IX, Director of Human Resources, Drury University
900 North Benton Avenue, Burnham Hall - Room 107, Springfield, MO  65802, (417) 873-7854, ssiebert@drury.edu; Deputy Coordinator - Non-Discrimination / Harassment & Title IX, V.P. for Academic Affairs / Dean of the College, Drury University, 900 North Benton Avenue, Burnham Hall - Room 200, Springfield, MO  65802, (417) 873-7391, ctaylor@drury.edu; Deputy Coordinator - Non-Discrimination/Harassment & Title IX, V.P. for Student Affairs / Dean of Students, Drury University, 900 North Benton Avenue, Findlay Student Center - Room 201, Springfield, MO  65802, (417) 873-7215, tjulian@drury.edu; Deputy Coordinator - Title IX, Associate Athletic Director, Drury University, 900 North Benton Avenue, O’Reilly Family Event Center - Room 111, (417) 873-7363
bcowherd@drury.edu

Drury’s policies related to non-discrimination and their locations are as follows:


Please complete and submit the fields below. Your application will be forwarded to our staff.

(* Indicates a required field)

*Today's Date: Aug 27, 2014
*Position Applied for:
*Last Name
*First Name
Middle Initial
*Last 4 digits of SSN
*Address
*City
*State
*Zip:
*Telephone:
*Alternate address/phone where you may be reached:
*E-mail:
Employment History (please begin with most recent):
*Employer:
*Job Title:
*Dates employed: From:
  To:
*Initial wage:
*Ending wage:
*Employer address:
*City
*State
*Zip:
*Work performed:
*Reason for leaving:
*Supervisor:
*Telephone:
*May we contact for reference?: Yes No

Employer:
Job Title:
Dates employed: From:
  To:
Initial wage:
Ending wage:
Employer address:
City
State
Zip
Work performed:
Reason for leaving:
Supervisor:
Telephone:
May we contact for reference?: Yes No

Employer:
Job Title:
Dates employed: From:
  To:
Initial wage:
Ending wage:
Employer address:
City
State
Zip:
Work performed:
Reason for leaving:
Supervisor:
Telephone:
May we contact for reference?: Yes No

Employer:
Job Title:
Dates employed: From:
  To:
Initial wage:
Ending wage:
Employer address:
City
State
Zip:
Work performed:
Reason for leaving:
Supervisor:
Telephone:
May we contact for reference?: Yes No

Employer:
Job Title:
Dates employed: From:
  To:
Initial wage:
Ending wage:
Employer address:
City:
State:
Zip:
Work performed:
Reason for leaving:
Supervisor:
Telephone:
May we contact for reference?: Yes No
Comments (including any gaps in employment):
 
Acquired Skills:
Typing / words per minute:
Computer: Personal Mainframe
Software:
Word Outlook Excel
DOS Power Point Access
Other Software:
 
Additional information that you feel may be helpful to us in considering your application. Summarize special job-related skills and qualifications:
 
Educational Background (please begin with most recent):
*School:
*Years completed:
*Degree/Diploma:
*Grade Point Average/ Class Rank:
*Major:
Minor:
 
School:
Years completed:
Degree/Diploma:
Grade Point Average/ Class Rank:
Major:
Minor:
 
School:
Years completed:
Degree/Diploma:
Grade Point Average/ Class Rank:
Major:
Minor:
 
Professional References:
1. *Name:
*Telephone:
*Years known:
 
2. *Name:
*Telephone:
*Years known:
 
3. *Name:
*Telephone:
*Years known:
 
Additional Information:
Can you provide proof of eligibility to work in the U.S.? Yes No
State any additional information that you would like us to consider:
 
*Have you been convicted of a felony? Yes No
If Yes, please explain. (Conviction may be relevant if job related, but does not bar you from employment):
 
*Are you capable, with or without reasonable accommodation, of performing in a reasonable manner the activities involved in the job or occupation for which you have applied? Note: Do not answer this question unless you have fully read the job description on the preceding page.
Yes No
 
* Are you related to anyone currently employed at Drury University?
Yes No
If so, please provide name(s)
*How did you find out about this job?
 
I certify that answers given herein are complete to the best of my knowledge.  I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.   In the event of employment, I understand that false or misleading information given in my application, resume or interview(s) may result in discharge.
 
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