Employment Application

Fill out the form below to Apply for employment at Campbellsville University.

You must also fill out the Background Check application.

Human Resources
1 University Drive, UPO 944
Campbellsville, KY 42718

Applications and Background Check Agreements will not be accepted without signatures in all appropriate places. A typed signature will not be accepted.

Employment Application

To apply, you must also complete the Background Check form

Step 1 of 6 - Application

Education History
High School Name*
Starting Date Attended*
Month
Day
Year
Ending Date Attended*
Month
Day
Year
High School Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Did you graduate?*
- Yes
- No
Course of Study*
Degree*
College (Undergraduate) Name
College (Undergraduate) Address
Address of College

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Starting Date Attended
Month
Day
Year
Ending Date Attended
Month
Day
Year
Did you graduate?
- Yes
- No
Course of Study
Degree
College (Graduate) Name
College (Graduate) Address
Address of College

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Starting Date Attended
Month
Day
Year
Ending Date Attended
Month
Day
Year
Did you graduate?
- Yes
- No
Course of Study
Degree
Technical/Vocational College Name
Technical/Vocational Address
Address of College

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Starting Date Attended
Month
Day
Year
Ending Date Attended
Month
Day
Year
Course of Study
Degree
Honors Awarded
Honors Awarded
Professional Certification/Licenses
Professional Certificational/Licenses
Computer Skills
Hardware
Software

Professional References Other Than Supervisors
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Daytime Telephone Number
Title/Occupation
May we contact?
- Yes
- No
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Daytime Telephone Number
Title/Occupation
May we contact?
- Yes
- No
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Daytime Telephone Number
Title/Occupation
May we contact?
- Yes
- No

Religious Affiliation
Name of Church with which you are currently affiliated
Name of Pastor
First Last
Phone
Address
Street Address or PO Box Address Line 2 City State / Province / Region ZIP / Postal Code Country
Give a statement of your personal Christian experience and beliefs*
Driving Information
PLEASE COMPLETE THIS SECTION ONLY IF DRIVING IS A REQUIRED PART OF THE JOB FOR WHICH YOU ARE APPLYING.
Driver's License Number
State
State
Expiration Date
Month
Day
Year
Is the above a valid driver's license?
- Yes
- No
Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
- Yes
- No
If you answered Yes, please add a statement giving details.
Has any license, permit, or privilege ever been suspended or revoked?
- Yes
- No
If you answered Yes, please add a statement giving details.
Have you had an accident in the past five (5) years?
- Yes
- No
If you answered Yes, please add a statement giving details.
Last Accident Date
Month
Day
Year
Nature of accident (head-on, rear-end, etc.)

Certification
I HEREBY AFFIRM THAT THE INFORMATION CONTAINED ON THIS APPLICATION IS ACCURATE AND COMPLETE. I GRANT CAMPBELLSVILLE UNIVERSITY PERMISSION TO CONTACT ALL REFERENCES AND/OR FORMER EMPLOYERS (UNLESS SO SPECIFIED) TO VERIFY INFORMATION NECESSARY TO ARRIVE AT AN EMPLOYMENT DECISION.

TO ASSIST CAMPBELLSVILLE UNIVERSITY IN COMPLYING WITH THE AMERICANS WITH DISABILITIES ACT, I AGREE TO DISCLOSE ANY ACCOMMODATION NEEDED TO PERFORM THE ESSENTIAL FUNCTIONS OF THE JOB AS DESCRIBED BY THE COMPANY PRIOR TO MY EMPLOYMENT.

I UNDERSTAND THAT HIRING IS SUBJECT TO VERIFICATION THAT I MEET THE LEGAL MINIMUM AGE REQUIREMENTS FOR EMPLOYMENT, AND THAT PERSONS UNDER THE AGE OF 18 MUST PROVIDE A VALID WORK PERMIT.

I HEREBY UNDERSTAND AND ACKNOWLEDGE THAT ANY EMPLOYMENT RELATIONSHIP WITH CAMPBELLSVILLE UNIVERSITY IS OF AN “AT WILL” NATURE. THIS MEANS THAT EMPLOYMENT IS WITHOUT A FIXED TERM. I MAY RESIGN AT ANY TIME, AND CAMPBELLSVILLE UNIVERSITY MAY DISCHARGE ME AT ANY TIME. I UNDERSTAND THAT NOTHING CONTAINED IN THE APPLICATION OR CONVEYED TO ME DURING ANY INTERVIEW THAT MAY BE GRANTED IS INTENDED TO CREATE AN EMPLOYMENT CONTRACT, IMPLIED OR EXPLICIT, BETWEEN CAMPBELLSVILLE UNIVERSITY AND ME. I UNDERSTAND AND AGREE THAT IF I AM HIRED, ANY FUTURE CHANGES IN JOB TITLE, DUTIES, COMPENSATION, WORKING CONDITIONS, AND/OR BENEFITS, POLICIES AND PROCEDURES WILL NOT ALTER OUR AT-WILL. I ALSO ACKNOWLEDGE THAT ONLY THE PRESIDENT OF CAMPBELLSVILLE UNIVERSITY IS AUTHORIZED TO ALTER OR MODIFY THE AT-WILL EMPLOYMENT AGREEMENT BETWEEN CAMPBELLSVILLE UNIVERSITY AND ME, AND THAT ANY SUCH ALTERATION OR MODIFICATION WILL BE VALID ONLY IF IT IS IN A WRITTEN DOCUMENT SIGNED BY THE PRESIDENT OF CAMPBELLSVILLE UNIVERSITY.

I UNDERSTAND THAT ANY FALSE OR MISREPRESENTED INFORMATION GIVEN ON THIS APPLICATION OR DURING THE INTERVIEW WILL PROVIDE SUFFICIENT CAUSE FOR REJECTION, OR IN THE CASE OF EMPLOYMENT, MAY RESULT IN MY DISCHARGE.

I UNDERSTAND THAT I AM REQUIRED TO ABIDE BY THE ADMINISTRATIVE POLICIES AND PROCEDURES MANUAL (AS AMENDED FROM TIME TO TIME) AND ALL POLICIES, RULES AND REGULATIONS ESTABLISHED BY CAMPBELLSVILLE UNIVERSITY.
Date*
MM slash DD slash YYYY
Signature
Electronic Signature*
First Name Last Name
*
- I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above and that all information has been answered truthfully.

WINTER TERM DEC. 26 - JAN. 7

Homecoming 2022 Schedule

Employment Application

Employment Application

Step 1 of 6 - Application

Employment History

U.S. Military History

Education History

Honors Awarded

Professional Certification/Licenses

Computer Skills

Professional References Other Than Supervisors

Religious Affiliation

Driving Information

Certification