Employee Transfer Application

Employee Transfer Application

The George Washington University does not unlawfully discriminate against any person on the basis of race, religion, sex, national origin, age, disability, veteran status, or sexual orientation. This policy covers all programs, services, policies, and procedures of the University, including admission to education programs and employment. The University is subject to the District of Columbia Human Rights Act. Inquires concerning the application of this policy and
federal laws and regulations concerning discrimination in education or employment programs and activities may be addressed to the Associate Vice President for Human Resources, The George Washington University, Washington, D.C. 20052, (202) 994-4433, to the Assistant Secretary for Civil Rights of the U.S. Department of Education, or to the Director of the U.S. Equal Employment Opportunity Commission/Washington Field Office. To request disability
accommodations, students should contact the Office of Disability Support Services, (202) 994-8250 (TDD/voice), and employees should contact the Office of Equal Employment Activities, (202) 994-9656 (voice) or 9650 (TDD).

PERSONAL DATA Name:

___________________________________________ ___________________________________

(Last)

(First)

(Middle)

Home Address:
Social Security #: Telephone #:

______________________________________________________________________________

(Street)

(City)

(State)

(Zip)

______________________________________________________________________________

Home: _______________ Work: _______________ E-mail Address: _____________________

EMPLOYMENT REQUEST Position Desired/Req #: Minimum Salary Desired: Would This Transfer Represent A:
Are You Eligible For Transfer Consideration? Will You Work Shifts?:

_____________________________________________________________________________ ___________________________________________________________________________ __

_____ Promotion

_____ Lateral

____ Voluntary Demotion*?

* For a voluntary demotion, please read statement below and sign

I understand that if I am offered and accept the position for which I am applying, my acceptance will result in a voluntary demotion because this position is at a lower salary grade than my current position. I also understand that my salary in this new position will be determined in consultation with the Director, Staffing and Compensation
Services and may result in a salary offer that is lower than my current salary. I further understand that the demotion will not be effective until I accept the new position and salary, and that rejection of the demotion will not affect my future eligibility for promotion, lateral transfer, or voluntary demotion at the University.

Signature: _______________________________________________________________ Date: ___________

Yes Yes*

No (Please see information on transfer eligibility at www.gwu.edu/hrs)

No *If Yes, Shift(s) Willing To Work:

Evening

Night

Weekend

EDUCATIONAL/VOCATIONAL DATA

Degree(s)/Major:

_________________________________________ ____________________________________

Relevant Training/Courses Taken: _____________________________________________________________________________

Relevant Licenses/Certifications: _ ___________________________________________________________________________

1 HRS 1/04

CURRENT GW WORK EXPERIENCE

Current Job Title:

__________________________________________________ Current Salary: _____________

GW Department:

__________________________________________________ Start Date: _________________

Duties (Not Necessary To Complete If A Resume
Is Attached And Includes Current Duties):

___________________________________________________________________________ ___

___________________________________________________________________________ ___

May We Contact Your Current Supervisor for
A Reference?

_______________________________________________________ _____________________ _ _ Yes _ _ No If Yes, Name & Telephone # of Supervisor: _______________________________

Is A Current Resume Attached? __ Yes _ _ No If Yes, Proceed To Agreement Section If No, Complete Other Work Experience Section Below And Then Go To Agreement Section

OTHER WORK EXPERIENCE - GW AND OTHER- BEGINNING WITH THE POSITION IMMEDIATELY BEFORE CURRENT POSITION

1. Job Title: _______________________________________________ Employer: ___________________ ___ _______ _______

Dates: From:

To:

Full-Time:

or Part-Time: ___ __

Duties: ______________________________________________________________ ______________________________ __

_______________________________________________________________________________________________

_______________________________________________________________________________________________

2. Job Title: ________________________________________________ Employer: _____________________________________

Dates: From:

To:

Full-Time: ______ or Part-Time: ______

Duties: _______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

3. Job Title: _________________________________________________ Employer: ____________________________________

Dates: From:

To:

Full-Time: ______ or Part-Time: ______

Duties: _______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

4. Job Title: _________________________________________________ Employer: ____________________________________

Dates: From:

To:

Full-Time: _______ or Part-Time: ______

Duties: _______________________________________________________________________________________________

_______________________________________________________________________________________________

_____________________________________________________________ __________________________________

HRS 4/01

PLEASE BE SURE YOU SIGN THE APPLICATION ON THE NEXT PAGE
2

WORKPLACE/COMPUTER SKILLS

What Workplace Equipment Can You Utilize?

______________________________________________ _____________________________

What Software Applications Do You Have A Working Knowledge Of?

_____________________________________________________________________________

Estimated Keyboard/ Typing Speed:

___________ (Complete Only If Position Desired Requires A Minimum Keyboard/Typing Speed)

OTHER DATA

Have You Ever Been Convicted of a Crime Other Than Minor Traffic Violations?

Yes*

No Note: A Yes Answer Will Not Necessarily Disqualify You For Transfer
Consideration. Each Conviction Will Be Reviewed In Relation To The Job For Which You Are Applying

*If Yes, For Each Conviction, Provide The Following Information:

When:

_____________________________________________________________________________

Where:

_____________________________________________________________________________

What For?:

_____________________________________________________________________________

AGREEMENT - READ AND SIGN
I understand that misrepresentation, omission, or falsification of information connected with my application for employee transfer (including resume) will be sufficient cause in and of itself for disqualification from employment opportunities or dismissal from employment whenever discovered.
Signature: _____________________________________________________________ ___________ Date: ________________

3 HRS 4/01