Florida Cooperative Extension Service

Application Form

INSTRUCTIONS:

1.  Please provide ALL information requested. Items left blank will indicate no valid information.

2.  Request official transcripts (s) (i.e. contains registrar’s signature and seal) of all courses to be sent to the Assistant Director, IFAS Human Resources.

3.  Request three (3) Reference Rating Forms be completed and sent to the Assistant Director, IFAS Human Resources. These forms can be located at: http://personnel.ifas.ufl.edu/jobs_apply.shtml

4.  Please include a copy of a resume outlining your work experience and other related information.

5.  Please include an intent letter addressed to the Assistant Director, IFAS Human Resources that describes how your experience and qualifications have prepared you for the position (s) your are applying.

6.  Please sign the application form certifying all entries are correct.

7.  Notify the IFAS Human Resources if you change your mailing address or telephone number.

GENERAL INFORMATION:

NAME (Please Print or Type):

DATE:

POSITION TITLE:

COUNTY OF POSITION:

HOW DID YOU HEAR ABOUT US?

Solutions for your life website

IFAS Personnel Website

UF Website

County Website

County Job Bulletin

IFAS Job Bulletin

Friend

Other:

Employment Application

Applicant Information

Full Name: / Date:
Last / First / M.I.
Address:
Street Address / Apartment/Unit #
City / State / ZIP Code
Phone: / () / E-mail Address:
Date Available: / Desired Salary: / $
Position Applied for:
Are you authorized to work in the U.S.? / YES / NO
Have you ever worked for this company? / YES / NO / If yes, when?
Have you ever been convicted of a felony? / YES / NO
If yes, explain:

Education

High School: / Address:
From: / To: / Did you graduate? / YES / NO / Degree:
College: / Address:
From: / To: / Did you graduate? / YES / NO / Degree:
Other: / Address:
From: / To: / Did you graduate? / YES / NO / Degree:

References

Please list three(3) persons who will complete the reference rating form at http://personnel.ifas.ufl.edu/howtoapply.htm
Full Name: / Relationship:
Company: / Phone: / ()
Address:
Full Name: / Relationship:
Company: / Phone: / ()
Address:
Full Name: / Relationship:
Company: / Phone: / ()
Address:

Previous Employment

Company: / Phone: / ()
Address: / Supervisor:
Job Title: / Starting Salary: / $ / Ending Salary: / $
Responsibilities:
From: / To: / Reason for Leaving:
May we contact your previous supervisor for a reference? / YES / NO
Company: / Phone: / ()
Address: / Supervisor:
Job Title: / Starting Salary: / $ / Ending Salary: / $
Responsibilities:
From: / To: / Reason for Leaving:
May we contact your previous supervisor for a reference? / YES / NO
Company: / Phone: / ()
Address: / Supervisor:
Job Title: / Starting Salary: / $ / Ending Salary: / $
Responsibilities:
From: / To: / Reason for Leaving:
May we contact your previous supervisor for a reference? / YES / NO

Military Service

Branch: / From: / To:
Rank at Discharge: / Type of Discharge:
If other than honorable, explain:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature: / Date:

Please submit to: Dana LeCuyer

Faculty Recruitment, IFAS Human Resources

University of Florida

P.O. Box 110281

Gainesville, FL 32611-0281

Telephone: 352-392-4777

Fax: 352-392-3226

Email:

The University of Florida is an Equal Employment Opportunity Institution

VOLUNTARY INFORMATION REQUEST

Thank you for submitting application materials to Florida Cooperative Extension, Institute of Food and Agricultural Sciences at the University of Florida. We sincerely appreciate your interest in this position. Your letter of application and other credentials will be forwarded to the Search Committee for their review and consideration.

To help better assess our search efforts, I would appreciate your completing an online data card. The card may be accessed at: http://www.hr.ufl.edu/job/datacard.htm. Please use the position number indicated for this position on the announcement. (NOTE: Be sure to remove all dashes from the number i.e. 00001111 **no dashes). Completion of this data card is strictly voluntary, but I encourage you to take a few minutes to provide this information. The information submitted is used to assist us and the University in fulfilling federal and state requirements and provides important feedback regarding our search efforts.

If you have any questions about the search and screening procedures or the status of your application, please contact me. Again, I appreciate your interest in this important position.

Sincerely,

Dana LeCuyer

Faculty Recruitment and Hiring