Staff Application

Personal Information

Name

Title First Middle Last Suffix

Present Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

Cell Phone

Have you ever worked or attended school under another name? If yes, please provide name.

Have you ever been convicted of a felony? If yes, give details.

Citizenship: Do you have the legal right to remain permanently and work in the United States?

Yes

No

Which of the following do you use?(Required)

Tobacco

Alcohol

Non-therapeutic/harmful drugs

None

Employment History

Please list positions for which you received wages, including military positions. Indicate all periods of self-employment (more than a month’s duration).

Company Name

Position/Title

Dates Employed

Number of Persons Supervised

Salary

Reason for Leaving

Name of Immediate Supervisor

First Last

Title of Immediate Supervisor

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Name

Position/Title

Dates Employed

Number of Persons Supervised

Salary

Reason for Leaving

Name of Immediate Supervisor

First Last

Title of Immediate Supervisor

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Name

Position/Title

Dates Employed

Number of Persons Supervised

Salary

Reason for Leaving

Name of Immediate Supervisor

First Last

Title of Immediate Supervisor

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Name

Position/Title

Dates Employed

Number of Persons Supervised

Salary

Reason for Leaving

Name of Immediate Supervisor

First Last

Title of Immediate Supervisor

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

High School

Name of High School

Date of Graduation

Month/Year

College / University

Name of College

Dates Attended

MM/YY - MM/YY

Major Field of Study

Date Degree Completed

Name of College

Dates Attended

MM/YY - MM/YY

Major Field of Study

Date Degree Completed

Name of College

Dates Attended

MM/YY - MM/YY

Major Field of Study

Date Degree Completed

Graduate School

Please list all Graduate schools you have attended.

Name of College

Dates Attended

MM/YY - MM/YY

Major Field of Study

Date Degree Completed

Name of College

Dates Attended

MM/YY - MM/YY

Major Field of Study

Date Degree Completed

Name of College

Dates Attended

MM/YY - MM/YY

Major Field of Study

Date Degree Completed

Correspondence or Night School

Name of College

Dates Attended

MM/YY - MM/YY

Field of Study

Date Degree Completed

Cover Letter and Résumé

Please upload either a Word Document or PDF file. Other files will not be accepted.

Upload a Cover Letter

Accepted file types: pdf, doc, Max. file size: 5 MB.

Upload your Résumé

Accepted file types: pdf, doc, Max. file size: 5 MB.

Professional Development

Do you have plans for additional study or professional development? If yes, briefly indicate your plans.

Please list organizations of which you are a member.

Please list your honors, recognitions, and distinctions.

References

Please list three people who may be contacted for professional references. All information will be treated confidentially.

Name

First Last

Position

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name

First Last

Position

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name

First Last

Position

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Standards of Employment at Hannibal-LaGrange University

The mission of Hannibal-LaGrange University is to provide an excellent liberal arts education in a distinctively Christian environment, thus preparing students for both personal and career effectiveness. As an academic institution which actively promotes the integration of learning with principles of the Christian faith, the University maintains a firm policy of employing only faculty and staff who share these commitments to academic quality and Christian lifestyle. Persons should apply for employment at Hannibal-LaGrange University only if they adhere to the following standards:

Is a born-again believer in Jesus Christ.
Has confessed his/her faith in Jesus Christ publicly and belongs to a Southern Baptist church.
Is faithful to the church of his/her choice, in terms of attendance and otherwise.
Believes the Bible to be God’s inspired, infallible Word.
Seeks to set a clean, upright, Christian example in daily life.
Refrains from all use of tobacco, alcohol and other harmful drugs.
Agrees to maintain loyalty to Hannibal-LaGrange University so long as he/she is in its employ.
Will abide by all regulations set forth by the University administration and trustees, including regulations specified in the Faculty and Staff Guide.
Believes the doctrines set forth in the following resolution adopted by the Missouri Baptist Convention on October 25, 1978:

WHEREAS, Missouri Baptists cherish dearly our abiding conviction that the Bible is a perfect treasure of divine instruction, which has God for its author, salvation for its end, and truth, without any mixture of error, for its matter; and

WHEREAS, we believe academic freedom should be balanced with academic responsibility and doctrinal integrity; and

WHEREAS, we acknowledge not only the right but the responsibility of this Convention to give explicit guidelines and directions to the governing bodies of our various institutions;

THEREFORE, be it resolved that we exhort the trustees of the colleges affiliated with or supported by the Missouri Baptist Convention to faithfully discharge their responsibility to carefully preserve the doctrinal integrity of our institutions, and to assure that colleges receiving our support only employ or continue the employment of faculty and staff members who believe in the inspiration of the whole Bible, the inerrancy of the original manuscripts, the existence of a personal devil and a literal Hell, the actual existence of a primeval couple named Adam and Eve, the literal occurrence of the miracles recorded in the Bible, the virgin birth and bodily resurrection, and the personal return of the Lord Jesus.

Please carefully read the following Applicant's Certification Agreement

By submitting this application, I understand and agree to the Standards of Employment at Hannibal-LaGrange University, and I certify that the facts set forth in this employment application are true and complete to the best of my knowledge and that falsified statements on this application, including intentional omissions, shall be considered sufficient cause for dismissal if employed.

Initial here to signify your agreement with the above statement.

Hannibal-LaGrange University complies with all federal and state nondiscrimination laws and does not engage in prohibited discrimination on the basis of race, color, sex, religion, disability, national or ethnic origin or ancestry, military or veterans status, or genetic information in either employment or the provision of services. As an institution controlled by the Missouri Baptist Convention, the University is exempted from some provisions of nondiscrimination laws, including the prohibition against religious discrimination in employment under Title VII of the Civil Rights Act of 1964, and, to the extent compliance would conflict with the University’s religious tenets, the prohibition against sex discrimination under Title IX of the Education Amendments of 1972.

A student or one seeking admission to Hannibal-LaGrange University, who claims to have been unlawfully discriminated against due to any University regulation, policy, or the official action of any University employee should submit a written complaint to Ashley Newton at HLGU, 2800 Palmyra Road, Hannibal, Missouri, 63401 or via email at ashley.newton@hlg.edu.

An employee or one seeking employment who claims to have been unlawfully discriminated against due to any University regulation, policy, or the official action of any University employee should submit a written complaint to Dori Colborn at Business Office, 2800 Palmyra Road, Hannibal, Missouri, 63401 or via email at dori.colborn@hlg.edu.

Approved by Board of Trustees October 14, 2016.

If hired at Hannibal-LaGrange University, I agree to abide by the Baptist Faith and Message 2000. If, for any reason, I am not able to abide by the Baptist Faith and Message 2000, I will inform the Office of Human Resources.(Required)

I agree

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