Achievers Summer Academy
If yes, please explain: Put N/A if you have no conviction.
Do you have driver's license? (yes/no):
Are you legally authorized to work in the United States? (yes/no):
Are you a graduate student or undergraduate?:
XXX-Large Name of High School:
Place of Employment:
Name of Supervisor:
All offers of employment, oral and written, shall include the following
statement: “This offer is contingent on the university’s verification of
credentials and other information required by state law and IU policies,
including the completion of a criminal history check.”
I certify that all information provided in all my application material is
true. I understand that any false statement made herein is sufficient reason
for rejection of this application or termination of subsequent employment
regardless of date of discovery. I authorize the University to
investigate all statements made in my application material for employment.
I authorize such educational institutions and employers and others
(and their agents or employees) to respond to questions concerning
information given in this application material and I further release from
liability such former employers, institutions, or persons providing such
information to the University.
Indiana University complies with the Drug-Free Workplace Act of
1988 and the Drug-Free Schools and Communities Act Amendments
of 1989. The unlawful manufacture, sale, distribution, dispensation,
possession or use of a controlled substance (usually referred to as illegal
drugs listed under the federal Controlled Substances Act) and alcohol
is prohibited on University property, or in the course of a University
activity, and may result in employee discipline up to and including
termination of employment.
I understand that direct deposit of my paycheck to my personal
checking or savings account is a condition of employment. I understand
that no offer of benefits such as a pension plan, insurance, vacation
or salary rate is final until cleared by Human Resources, and fully
approved by appropriate University officials.