Application for Employment
After filling out this form, you must print it,
sign it and either mail or fax to:
Human Resources Office
221 College Lane
Salem, VA 24153
(fax) 540-378-5165
If assistance is needed to complete the
application, please let us know.
Date:
We are pleased with your interest in employment with Roanoke College. We offer equal opportunities to all persons
and will consider your application accordingly.
PERSONAL
Name:
Telephone #:
Address: Street, City, State, Zip Code
Position applying for: (Must list specific position)
Full-time
Date available for Work:
Part-time
Temporary
Salary Expected:
Have you ever been employed by Roanoke College?
If yes, give title, employment dates and department(s).
No
Yes
Note: If hired, proof of identity and authorization to work in the U.S. will be required on your first day of employment via an I-9 form. If applying for a
position requiring the driving of a motor vehicle, do you have a valid license for the type of vehicle to be operated?
Yes
No
Have you ever been convicted of a felony?
No
Yes If yes, state details (offense, place of occurrence, date, penalty)
Note: Convictions are not an automatic bar to employment. Each case is considered on its individual merits and the type of work applied for. However,
false statements or withholding information will result in being barred from appointment, or removal from employment.
EDUCATION
List Schools Attended (Begin with high school)
Degree/ Diplomas Awarded
Course of Study
ROANOKE COLLEGE APPLICATION -- PAGE 2
EXPERIENCE
Name, Address, & Telephone # of
Employer (List current first)
1.
Dates Employed
Position Held
Salary
Reason for Leaving
2.
3.
4.
5.
May we contact the employers above?
No
Yes
If no, indicate which one(s) you do not wish us to contact:
PROFESSIONAL REFERENCES (other than relatives)
Name/Occupation
1.
Address
Daytime Telephone Phone Number
2.
3.
AGREEMENT
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that any falsification,
misrepresentation or concealment of any material fact will cause my application for employment to be rejected and, if employed, may result in
dismissal from employment.
I authorize investigation of all statements contained herein and further authorize the references listed above to give you any and all information
concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability that
may result from furnishing same to you.
In consideration of my employment, I acknowledge my employment is at will and therefore my employment and compensation can be terminated with
or without cause and with or without notice at any time, at the option of the college or myself. I understand that no representative other than the
President of the college has any authority to enter into any agreement for employment for any specified period of time or to make any agreement
contrary to the foregoing, and any representations contrary to the foregoing are expressly disavowed, shall not be binding upon the college and
should not be relied upon by any applicant or existing employee, unless made in writing and signed by the President. I further acknowledge that any
personnel manual, handbook, publication, policy, procedure, rule or regulation that may now or in the future apply to me is not contractual in nature
and is not intended to modify the foregoing employment relationship.
I have carefully read, understand and agree to all of the provisions, terms and conditions contained in this application for employment.
Applicant’s Signature
Date
Roanoke College publishes an Annual Security Report. A copy is available to all Applicants on request.