Employment Application

Name:
Penn ID:
Local Address:
Street:
City:
State:
Zip Code:
Primary Telephone:
Secondary Telephone:
E-mail:
Permanent Address (if different):
Street:
City:
State:
Zip Code:
Home Telephone:
What semester are you applying for? Year Fall Spring Summer
Position You Are Applying For (please check one):
Operations Assistant Operations Supervisor
Lifeguard Climbing Wall Assistant
Aquatics Instructor Group Exercise Assistant
Group Exercise Instructor Instructional Class Instructor
Personal Trainer Equipment Maintenance Manager
Fitness Attendant Membership Services
Intramural Official Intramural Supervisor
Intramural Office Assistant Website Coordinator
Desktop Publisher Massage Therapist
 Applicant Status :
Penn Student
Penn Athlete
Other(Part-Time Employees are limited to 1,000 hours per fiscal year)
Major? Date of Graduation?
Will you receive Work Study? Yes     No
Are you currently or have you ever been employed by Penn? Yes No
If yes,when and where were you employed?
If hired, would PennRec by your only Penn employment? Yes No
Are any of your relatives PENN Employees? Yes No
If yes, please give their name & department:
Why do you want to work for the Department of Recreation?
What can you bring to the Department of Recreation?
What certifications do you currently hold?
List all experienes relating to the position for which you have applied.
How did you hear about this position?
Employment History
Present Employer:
Job Responsibility:
Supervisor:
Telephone:
Previous Employer:
Job Responsibility:
Job Supervisor:
Supervisor Telephone:
Reason(s) for Leaving:
When can you start?

Nondiscrimination Statement

“The University of Pennsylvania values diversity and seeks talented students, faculty and staff from diverse backgrounds. The University of Pennsylvania does not discriminate on the basis of race, color, sex, sexual orientation, gender identity, religion, creed, national or ethnic origin, citizenship status, age, disability, veteran status or any other legally protected class status in the administration of its admissions, financial aid, educational or athletic programs, or other University-administered programs or in its employment practices. Questions or complaints regarding this policy should be directed to the Executive Director of the Office of Affirmative Action and Equal Opportunity Programs, Sansom Place East, 3600 Chestnut Street, Suite 228, Philadelphia, PA 19104-6106; or (215) 898-6993 (Voice) or (215) 898-7803 (TDD).

Please read carefully and acknowledge:

I have carefully read the application statement and have provided accurate information to the best of my knowledge. The facts set forth in this application are true and complete. Permission is given to the University of Pennsylvania to verify all information I have provided in this application. I authorize all persons or entities I have referred to in this application to provide any relevant information to the University of Pennsylvania or its agents for use in investigation and release them from any liability doing so.

I understand and agree that any omission or misrepresentation of facts in my application will be justification for refusal or termination of employment. I understand that this employment application and any other University documents or statements are not contracts of employment. I acknowledge that employment at University of Pennsylvania is at will, meaning I will be free to leave at anytime and my appointment may be terminated for any reason at any time. Employment is contingent upon satisfactory completion of employment and reference checks. A minimum of two reference checks are required for employment, one of which must be from the applicant’s current supervisor.”