The University of Iowa

UI Department of Public Safety Application for Student Employment

Please be specific and detailed in your answers.

1 Application 2 Preview 3 Complete
Personal Information

The University of Iowa prohibits discrimination in employment and in its educational programs and activities on the basis of race, national origin, color, creed, religion, sex, age, disability, veteran status, sexual orientation, gender identity, or associational preference. The University also affirms its commitment to providing equal opportunities and equal access to University facilities. For additional information on nondiscrimination policies, contact the Coordinator of Title IX, Section 504, and the ADA in the Office of Equal Opportunity and Diversity, (319) 335-0705 (voice) and (319) 335-0697 (text), 202 Jessup Hall, The University of Iowa, Iowa City, Iowa 52242-1316.

Employment Information

List ALL positions you have held, starting with your most recent. If you held more than one position with the same organization, or in the case of the military, had different assignments, list each separately. Please be sure to include your duties, as this will help to determine your qualifications. The University of Iowa Department of Public Safety requests this information for the purpose of evaluating your training and experience to assist in the evaluation of your qualifications for specific positions. No persons outside the University of Iowa are routinely provided this information, except for directory information such as name and local addresses. If you fail to provide the required information, the University of Iowa Department of Public Safety may not be fully evaluate your training and experience.

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I certify that all information given on this application is correct to the best of my knowledge and I hereby authorize the Department of Public Safety to check my past work experience. This (includes) (does not include) my present employer. I understand that any known misrepresentation or omission of information requested is grounds for rejection of my application.