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Employment Application

Programs, services, and employment at UAC are equally available to everyone. Please inform the Human Resources Department if you require a special accommodation for the application or interview. UAC is a drug free workplace, and drug testing is part of the screening process as well as part of ongoing employment at UAC.

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Full name (First, Middle, Last): *

Address: *

City: *

State: *

Zip: *

Phone: *

Mobile/Pager/Other:

Email: *

Date Available to Start: *

Expected Wage/Salary: *

If you are under 18 and we require a work permit, can you furnish one? Yes No

If no, please explain:

Have you ever worked for this company? * Yes No

If yes, please tell more about it:

Are you a citizen of the United Sates? * Yes No

If not, are you legally allowed to work in the United States? Yes No

Type of employment desired: *

Have you ever pled "guilty," "no contest," or been convicted of a crime? * Yes No

If yes, give dates and details:

Answering "Yes" to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation, and position applied for will be considered.

Driver's license number if applicable to position:

Driver License Issued State:

Summarize Your Special Skills or Qualifications: *

Previous Employment:

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial, and other related matters as may be necessary for an employment decision.
I hereby release employers, schools, or individuals from all liability when responding to inquires in connection with my application.
In the event I am unemployed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

1. What is your Gender?	Male Female
2. Are you Hispanic or Latino?	Yes. Hispanic/Latino means a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin, regardless of race. If you check this box, skip question 3. No. Continue to next question.
3. What is your race?	White: A person having origins in any of the original peoples of Europe, the Middle East or North Africa Black or African American: A person having origins in any of the black racial groups of Africa Native Hawaiian or Other Pacific Islander: A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands. Asian: A person having origins in any of the original peoples of the Far East, Southest Asia, or in the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam. American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America) and who maintains cultural identification through tribal affiliation or community recognition. Two or More Races: All persons who identify with more than one of the above five races
I decline to provide information about my race and gender

Start Date: *		End Date: *
Position: *
Firm Name: *		Firm Address:
Supervisor Name: *		Firm Phone: *
Responsibilities: *
Starting Title: *		Starting Compensation: *
Ending Title: *		Ending Compensation: *
Reason for Leaving: *
May we contact this employer as a reference? *
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University Air Center

North Florida's Aviation Headquarters

Employment Application

Application Data:

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