logo 36600 Schoolcraft Road
Livonia Michigan 48150-1173
Phone 734-432-5675
Fax 734-432-5587
APPLICATION FOR EMPLOYMENT (Non-Faculty positions only)
Madonna University is an independent, coeducational, Catholic liberal arts university sponsored by the Felician Sisters of Livonia, Michigan. The University, founded in 1947, is an outgrowth of Presentation Junior College (1937-1947). Through a strong general education curriculum integrated with liberal arts and career-oriented majors, the University offers programs leading to doctoral, master’s, bachelor’s and associate degrees and certificates.

Human Resources: 734-432-5675
Email: hr@madonna.edu

All Madonna University Buildings are Smoke-Free
* indicates required fields.
PERSONAL DATA

*Last Name:    *First Name:    Middle Name: 
*Street:    *City:    *State:    *Zip: 
*Home Phone:     Cell Phone:     Business Phone: 
*Email Address:    *Are you 18 or older?    
*Are you legally eligible to work in the U.S. (verification will be required upon hire)?   
*Have you ever been convicted of a crime other than a minor traffic violation?    
If yes, please give details including date & disposition.
Religious Affiliation
(Allowable Request in a religiously affiliated educational institution)

POSITION INFORMATION

*Position(s) for which you are applying: 
*Minimum salary requirements: $/Hr.   $/Year How did you learn of this position? 
*Explain briefly how you meet the qualifications of this position:
*Can you perform all the essential duties of this position without reasonable accommodation?   
If no, please explain.

EDUCATION RECORD

Name and Location of School or InstitutionTotal Credits Major FieldDid You Graduate?Degree or Certificate Received
High School or GED:
College:
College:
Trade/Professional:

EMPLOYMENT HISTORY

Present/Last Employer
Employer Phone
Starting and Ending Dates
to
Address/City/State
/ /
Name and Title of Supervisor
Job Title and Duties
Hours Per Week
Why did you leave?
Beginning Salary
Ending Salary
*May we contact this employer?           

Previous Employer

Employer Phone

Starting and Ending Dates
to
Address/City/State
/ /
Name and Title of Supervisor
Job Title and Duties
Hours Per Week
Why did you leave?
Beginning Salary
Ending Salary
May we contact this employer?           

Previous Employer

Employer Phone

Starting and Ending Dates
to
Address/City/State
/ /
Name and Title of Supervisor
Job Title and Duties
Hours Per Week
Why did you leave?
Beginning Salary
Ending Salary
May we contact this employer?           

Previous Employer

Employer Phone

Starting and Ending Dates
to
Address/City/State
/ /
Name and Title of Supervisor
Job Title and Duties
Hours Per Week
Why did you leave?
Beginning Salary
Ending Salary
May we contact this employer?           

REFERENCES

List two professional references (those that can attest to your work experience and work ethic):
Name
Phone
Occupation
Relationship
Name
Phone
Occupation
Relationship

I hereby represent that the data provided by me in this application is complete and true to the best of my knowledge and may be verified by Madonna University. I understand that any incorrect, incomplete or false statement of information furnished by me may subject me to dismissal.
I hereby authorize Madonna University, and/or its agents, to contact my current and/or former employers to give any information regarding my employment with them, and I waive the requirement for any written notice from my current and/or former employers in accordance with Michigan Public Act 397/1978.
I further authorize the Department of State Police, Central Records Division, to conduct a motor vehicle record search and/or a criminal history file check by name and identifiers to determine the existence of any arrest resulting in conviction and furnish a response to Madonna University.
I agree that any claim or lawsuit relating to my service with Madonna University must be filed no more than six (6) months after the date of employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary. However, I agree that any shorter statute of limitations remain in effect.
I understand that this application does not create a contract of employment for any definite period of time. If employed, I understand that I have been hired at the will of Madonna University and that my employment may be terminated at any time, with or without cause and with or without notice.
My signature below indicates that I have read and understood the above paragraphs.
*Type your name here for your signature:   Date:03/01/2015