WOU Classified Position Employment Application

An Equal Employment Opportunity Employer in Compliance with the Americans with Disabilities Act

Employment Application
Classified Staff

Please Note: Applicants who require any physical or other assistance in completing this application
may contact the Office of Human Resources at 503-838-8490 or employment@wou.edu

All Information below is Optional and Confidential.
This information is used by the WOU Office of Human Resources only
and is not seen by the hiring department/office.

Affirmative Action Information:

Gender(check one):
Male:
Female:

Ethnicity(check one - see below for definitions):
Asian/Pacific Islander: American/Alaskan Native: Black/African American: Hispanic: White:

Asian/Pacific Islander: All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent or the Pacific Islands. The area includes, for example: China, Japan, Korea, the Philippine Islands and Samoa.

American/Alaskan Native: All persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.

Black/African American (not of Hispanic origin): All persons having origins in any of the black racial groups.

Hispanic: All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.

White (not of Hispanic origin): All persons having origin in any of the original peoples of Europe, North Africa or the Middle East.

Veteran Status Information
(check one - see below for definitions) Special Disabled Veteran: Vietnam Era Veteran: Newly Separated Veteran: Other Protected Veteran:

Special Disabled Veteran: Either a) a veteran who is entitled to compensation (or who would be but for the receipt of military retired pay) under laws administered by the Department of Veteran Affairs for a disability (i) rated at 30% or more, or (ii) rated at 10 or 20% in the case of a veteran who has been determined under Section 1506 of Title 38, to have a serious employment handicap; or b) a veteran who was discharged or released from active duty because of a service-connected disability.

Vietnam Era Veteran: A veteran whose active military, naval, or air service (or any part of it) was during the period beginning August 5, 1964 and ending May 7, 1975, provided that either of the following is true: 1) the veteran served on active duty for a period of more than 180 days and was discharged or released with other than a dishonorable discharge, or 2) the veteran was discharged or released from active duty because of a service-connected disability.

Newly Separated Veteran: Any veteran who served on active duty in the U.S. military, ground, naval or air service during the one-year period beginning on the date of such veteran's discharge or release from active duty.

Other EligibleVeteran: A veteran who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized. For guidelines on identifying campaigns or expeditions that meet this criterion, go to http://www.opm.gov/veterans/html/vgmedal2.htm.

Advertising Information - Where did you hear about this position?
Newspaper: Specify Newspaper:
WOU Web Page:
Other Web Page: Specify Web Page:
Oregon Employment Department:
WOU Human Resources Office:
WOU This Week:
Posted on Campus:
Friend/Coworker:
Other Source: Specify Source(optional):

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Before continuing, please check your entries.

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Position Information
Job Title (required):
Department/Office (required) :
Job Recruitment Number (required):

Applicant Information
First Name (required):
Last Name (required):
Street Address (required):
City (required):
State (required):
Zip (required):
Home Phone:
Work Phone:
Message Phone:
E-Mail:

Are you over the age of 18? (required):
Yes: No:

Are you legally eligible for employment in the United States (Immigration Reform and Control Act of 1986)? (required):
Yes: No:

Have you ever been charged and/or convicted of a felony or any offense involving dishonesty?* (required):
Yes: No:
*Note: A conviction does not necessarily eliminate you from employment consideration. Each conviction will be reviewed with respect to the offense, circumstances, seriousness, and the position for which you apply.

Have you ever been employed or are you currently employed by an Oregon University System institution(s) or by the Chancellors Office?(required):
Yes: No:

If yes, list the name(s) of the institution(s) and the dates to/from that you worked there (separate listings with a semicoln(;)) [Maximum length = 2000 characters] (required):
Please list the name and department of any relatives who work for WOU (This response is considered for placement purposes. WOU does not place relatives in positions which create supervisory/subordinate relationships): [Maximum length = 2000 characters]