UCI Employment Application

Employment Eligibility

Are you 18 or older?*

Yes No

Are you legally eligible for employment in the Unites States of America? (Proof of U.S. Citizenship or immigration status will be required upon employment):*

Yes No

Thank you for your interest in UCI. At this time, we are unable to accept your application.

Personal Information

Please fill out all the required fields and attach your resume below.

Today's Date:*

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Have you ever worked for UCI?*

Yes No

Employment Desired*

Full-time Part-time Either

Desired Salary / Hourly Wage*

Phone Number:*

Email*

Have you served in, or do you currently serve in the military?*

Yes No

Additional Information

What is the longest you have been employed by a company (months)?*

Ex. One and half years = 18 months

Can you travel for work?*

Yes No

DateAvailable to start work:*

If referred by a UCI employee, please provide the name:

First Name

Last Name

EDUCATION

Highest level of formal education completed:*

No High School Diploma or GED High School Diploma GED Technical or Trade School Associate Degree (2 Year) Bachelors Degree (4 Year) Graduate Degree or Higher

Name of High School or GED Facility:*

Technical or Trade School Attended and certifications completed:*

Associates degree received and college it was issued by:*

Bachelor's degree received and college it was issued by:*

Masters degree or Doctorate received and college it was issued by:*

Skills

Previous Employer #1

Most recent employer:*

Phone number of most recent employer:*

Position held at most recent employer:*

Final wage or salary at most recent employer:*

Start date at most recent employer:*

Last date at most recent employer: *

Employment Status:*

I currently work for this employer I voluntarily resigned from this employer on good terms I was laid-off by this employer I was terminated by this employer

Previous Employer #2

Employer #2:

Phone number of employer #2:

Position held at employer #2:

Final Wage or salary at employer #2:

Start date at employer #2:

Last date at employer #2:

Employment Status employer #2:

I currently work for this employer I voluntarily resigned from this employer on good terms I was laid-off by this employer I was terminated by this employer

Previous Employer #3

Employer #3:

Phone number of employer #3:

Position held at employer #3:

Final Wage or salary at employer #3:

Start date at employer #3:

Last date at employer #3:

Employment Status employer #3:

I currently work for this employer I voluntarily resigned from this employer on good terms I was laid-off by this employer I was terminated by this employer

List any other relevant employers or work history not provided above

Other Information

Have you ever been convicted of a felony?*

Yes No

If yes, list all convictions, date of conviction, and sentence imposed

How did you find out about this position?

Current Employee Newspaper or Radio Ad Job Board (Ziprecruiter, indeed, etc.) Facebook/ Linkedin Search Engine

Other:

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