Academic Employment Application Home > About Us > Employment > Academic Employment Application Academic Employment Application Δ Step 1 of 6 16% PositionPlease supply the information below as supplied in the position listing. (View Position Listings)Name of position for which you are applyingDate you can start MM slash DD slash YYYY Are you employed currently? Yes No If so, may we contact your present employer? Yes No Have you previously applied to this University? Yes No In what area?When? MM slash DD slash YYYY Personal InformationName(Required) Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary Contact Number(Required)Alternate NumberEmail(Required) Are you 18 years or older?(Required)YesNoAre you authorized to work lawfully in the United States?(Required)YesNoWill you now, or in the future, require sponsorship for employment Visa status (e.g., H-1B, visa status)?(Required)YesNoIf yes, please provide explanationHave you ever worked at Belmont Abbey College?(Required)YesNoIf yes, indicate dates of employment and positions(Required)Have you ever been convicted of any law violation (except a minor traffic violation)?(Required)YesNoA “yes” answer does not automatically disqualify you from employment, since the nature of the offense, date and the job for which you are applying will also be considered. If yes, please provide explanation(Required) Voluntary Demographic Data Belmont Abbey College is an equal employment employer. It is the policy and practice of Belmont Abbey College to recruit and select applicants on the basis of their qualifications and ability without regard to race, color, religion, national origin, age, sex, disability, or veteran status. This effort is in compliance with all federal and state laws, including, but not limited to, Title VI and VII of the Civil Rights Act of 1964, Title IX of the Educational Amendments of 1972, Section 504 of the Rehabilitation Act of 1975, and the Americans with Disabilities. Applicants are invited to answer the demographic questions below. Information provided by the applicant is confidential and will be used ONLY for statistical compilation. Providing responses is completely voluntary and no applicant will be negatively affected by not providing responses. This information will not be part of the institution’s employment decision regarding the applicant, and will not be seen by anyone involved in the hiring decision. Thank you in advance for your time and cooperation. GenderMaleFemaleDecline to AnswerAre you Hispanic or Latino?YesNoDecline to AnswerRace Category American Indian Alaskan Native Black or African American Asian Native Hawaiian or Pacific Islander White Decline to Answer Voluntary Self Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier. How do I know if I have a disability? You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Blindness Autism Bipolar disorder Post-traumatic stress disorder (PTSD) Deafness Cerebral palsy Major depression Obsessive compulsive disorder Cancer HIV/AIDS Multiple sclerosis (MS) Impairments requiring the use of a wheelchair Diabetes Epilepsy Schizophrenia Muscular dystrophy Missing limbs or partially missing limbs Intellectual disability (previously called mental retardation) Please check one of the boxes below YES, I HAVE A DISABILITY (or previously had a disability) NO, I DON’T HAVE A DISABILITY I DON’T WISH TO ANSWER Your NameToday's Date Month Day Year Reasonable Accommodation Notice Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment. i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp. PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete. Voluntary Self Identification of Protected Veteran Status Definitions This employer is a Government contractor subject to the Vietnam Era Veteran’s Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment; (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows: A “disabled veteran” is one of the following: A veteran of the U.S. military, ground, naval, or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation (under laws administered by the Secretary of Veterans Affairs; or A person who was discharged or released from active duty because of a service-connected disability A “recently separated veteran” means any veteran during the three year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service. An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval, or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval, or air service, participated in a U.S. military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. Protected veterans may have additional rights under USERRA – the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll free, at 1-866-4-USA-DOL. Self-Identification As a Government contractor subject to VEVRAA, we are required to submit a report to the United States Department of Labor each year identifying the number of our employees belonging to each specified “protected veteran” category, If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. Self Identification I belong to a classification of protected veterans I am a protected veteran, but I choose not to self-identify the classifications to which I belong. I am NOT a protected veteran. Protected Veteran Classification DISABLED VETERAN RECENTLY SEPARATED VETERAN ACTIVE WARTIME OR CAMPAIGN BADGE VETERAN ARMED FORCES SERVICE MEDAL VETERAN Choose all that apply. Military Discharge Date Month Day Year Type Full NameToday's Date Month Day Year If you are disabled veteran if would assist us if you tell us whether there are accommodations we could make that would enable you to perform the essential functions of the job, including special equipment, changes in the physical layout of the job, changes in the way the job is customarily performed, provision of personal assistance services or other accommodations. This information will assist us in making reasonable accommodations for your disability. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended. The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel may be informed, when and to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) Government officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed. Application SubmissionHow did you hear of this employment opportunity? Belmont Abbey College website Catholicjobs.com Higheredjobs.com Website Professional Affiliation Website Advertisement in Academic or Professional Publication Referred by a current or former employee Conference or career fair Other Current or former employee who referred you.Documents needed to complete your application Please note: To upload multiple documents of the same type, i.e. two transcripts, you must combine the documents into a single PDF or Word document before clicking on the “browse” button, or use the “Other Documents” option. (If applicable) Cover Letter/Letter of Interest Resume/Curriculum Vitae Statement of Interest and Understanding of the Mission of Belmont Abbey College References Transcripts Other Document Upload(Required) Drop files here or Select files Max. file size: 70 MB. Certification I understand that this application or subsequent employment does not create a contract of employment nor guarantee employment for any definite period of time. If employed, I understand that I have been hired at the will of the employer and my employment may be terminated at any time, with or without cause and with or without notice. By selecting the check box below, I assert that all information given in this application is true. I understand that false information (misrepresentation or omission of information) may be the basis for disqualification or termination of employment. I authorize investigation of all statements contained herein. (Required) I certify that I have read and agree with these statements Type Full Name(Required)Today’s Date(Required) Month Day Year