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Human Resources department also needs a copy of this competed form .  \n(PLEASE PRINT OR TYPE AND CHECK APPROPRIATE CIRCLES)  \nPOSITION INFORMATION  \nFor what position are you applying?   Application Date    \nMo Day Year  \nDepartment/Division   How many hours per week?   Have you ever been employed with CBU before? [ ] Yes [ ] No If Yes, please give dates:  /   Verification of eligibility to work in the United States will be required as a condition of employment in the position. This includes completion of INS I-9 form and verification of identification documents.  \nCan you provide these documents? [ ] Yes [ ] No  \nPERSONAL INFORMATION  \n\n| Last Name First Middle Initial Social Security Number\u003Cbr>8432 Magnolia Ave    Riverside  CA  92504\u003Cbr>On Campus Address (if applicable) Campus Box Number City State Zip\u003Cbr>(  )  (  )   @[calbaptist.edu](calbaptist.edu)\u003Cbr>[Home Phone /with area code Cell Phone /with area code CBU Email Address](Home Phone /with area code Cell Phone /with area code CBU Email Address) |\n| --- |\n| Permanent Street Address: Number and Street City State Zip\u003Cbr>  (   ) \u003Cbr>Person to notify in an Emergency: Last Name First Name Phone /with area code\u003Cbr>Student ID \\#   Are you currently enrolled at CBU? [ ] Yes [ ] No\u003Cbr>Academic Major   Year in School/Completed Units  \u003Cbr>Other on-campus involvement (FOCUS, RA, ASCBU, etc. )  \u003Cbr>Continue on reverse side\u003Cbr>A Christian University--A Member of the Association of Independent California Colleges and Universities\u003Cbr>EMPLOYMENT HISTORY |\n\n\n| 1. EMPLOYER (Present or Last) May we contact? [ ] Yes [ ] No\u003Cbr>Name of Employer Street City Zip Area Code Telephone\u003Cbr>Describe work performed: Name of Supervisor\u003Cbr>__________________________________________________________________ | Job Title Dates Employed From/To (Mo/Yr)\u003Cbr>Reason for Leaving:\u003Cbr>_____________________________ |\n| --- | --- |\n| 2. EMPLOYER (Present or Last) May we contact? [ ] Yes [ ] No\u003Cbr>Name of Employer Street City Zip Area Code Telephone\u003Cbr>Describe work performed: Name of Supervisor\u003Cbr>__________________________________________________________________ | Job Title Dates Employed From/To (Mo/Yr)\u003Cbr>Reason for Leaving:\u003Cbr>_____________________________\u003Cbr>_____________________________ |\n\nAPPLICANT’S AGREEMENT CLAUSE AND SIGNATURE  \nI understand that my Student Application for Employment will not be seriously considered, if it is considered by California Baptist University to be significantly incomplete. The information provided in this application is true, correct, and complete to the best of my knowledge. I understand the position for which I am applying is a student worker position and does NOT have employee benefits. I agree to receive my earned wage either semi-monthly or by stipend at the option of the university. I understand and agree that I could receive my last and final paycheck by USPS mailed to my permanent address listed on the reverse side of this form or an updated address on record. I understand that if hired, I may not begin work without first submitting a completed Student Employee Checklist with accompanying documents to the Human Resources Office. I understand and agree that, if employed, either CBU or I will be free to terminate the employment relationship at any time, with or without cause and with or with out notice.  \nDate  / /  Signature    \nMo. Day Year  \nEMPLOYER’S USE ONLY  \nPosition Open? [ ] Yes [ ] No Application Complete? [] Yes [ ] No Interview? [ ] Yes [ ] No","cbCaimX1Hxppn8vw","https://ap.wps.com/l/cbCaimX1Hxppn8vw","pdf",56125,6,"English","# Position Information\n## Personal Information\n# Employment History\n# Applicant’s Agreement Clause and Signature\n# Employer’s Use Only","[{\"question\":\"What is the purpose of this student employment application form?\",\"answer\":\"It enables applicants to apply for open student worker positions and provides departments with complete, accurate information.\"},{\"question\":\"What eligibility and document requirements are listed for employment in the United States?\",\"answer\":\"Applicants must provide documents required for INS I-9 completion and identification verification as a condition of employment.\"},{\"question\":\"What does the applicant agreement clause require the applicant to acknowledge?\",\"answer\":\"The applicant acknowledges the application must be complete, that the role is a student worker position with no employee benefits, agrees to wage payment timing options, and understands employment can be terminated with or without cause and with or without notice.\"}]","Student Employment Application Form - Signature and Eligibility Information | PDF",1789306737]