The University of Wyoming Application for Non-Benefited
Temporary Employment
Human Resources Department
Room 139, Wyoming Hall
1000 E. University Ave.
Dept. 3422
Laramie, Wyoming 82071
Phone: (307) 766-2215
Fax: (307) 766-5607
TDD: (307) 766-2216
http://www.uwyo.edu/hr
The University of Wyoming is an Equal Opportunity Affirmative Action Employer
Name
(Print)
Address
(Last)
(First)
(Middle)
Telephone Number
E-mail Address
Are you a U.S. citizen or currently authorized to work in the United States on a full-time basis?
Have you ever been convicted of or pled guilty or nolo contendere/no contest to any felony?
Yes
Yes
No
No
If yes, please explain:
If the answer above is yes, you must provide a certified copy of conviction and any other pertinent, clarifying
documents to the Human Resource Department.
Have you ever been convicted of or pled guilty or nolo contendere/no contest to a sex
Yes
No
crime against a minor or a sex crime involving violence?
If yes, please explain:
If the answer above is yes, you must provide a certified copy of conviction and any other pertinent, clarifying
documents to the Human Resource Department.
Date Available for Employment
Number of Hours Work Desired Per Week
Current UW Employee?
If Yes Where?
Hours Available for Work
Skills/Licensure (Please check if proficient/trained in)
Monday
Typing (wpm)
Calculator
Custodial
Tuesday
Computer
Cashier
Foreign Language
Wednesday
Word Processing
Bookkeeping/Ac
Valid Driver's License
ct.
Thursday
Spreadsheet
Phone/Reception
OTHER
Friday
Database
Sales
Saturday
Data Entry
Food Service
Sunday
Graphics
Library
List your employers, starting with your current or most recent employer. Please indicate any previous UW
employment. It may be helpful to attach a resume. You may also include volunteer experience.
Current/Last Employer:
Dates Worked:
City/State:
Reason for Leaving:
Position Title:
Major Duties/Activities:
Employer:
City/State:
Position Title:
Major Duties/Activities:
Dates Worked:
Reason for Leaving:
I certify that all information given on this application, supporting documents, and interviews are correct to the best of my knowledge. I understand that
giving false information may disqualify my application or result in termination. I understand that this application is not intended to be a contract of
employment. I authorize the university to investigate all statements made on my application for employment. I authorize such educational institutions and
employers and others (and their agents or employees) to respond to questions concerning information given on this application and I further release from
liability the University of Wyoming, such former employers, institutions, or persons providing such information. I understand that no salary rate is final
until approved by the Human Resources Department. Federal law requires employers to document the identity and employment authorization of each new
employee.
Signature
Date
If you are a person with a disability and need an accommodation for the application/interview process, please call
307-766-2215.
Updated 07/25/07