Graduate School - Work Experience

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If you prefer, you may complete all fields, print and mail to: Franklin University, Graduate Programs, 201 S. Grant Ave., Columbus, Ohio 43215-5399 or fax to 614.947.6771.

Applicant Name:
Applicant Social Security number:
Date of Birth:	- -
Total number of years of full-time professional work experience:
Note: Internships may not count toward experience

Please complete this form by providing the requested information for the last four positions you have held. List only three different positions within the same company. Begin with your current or most recent position. If you are not currently employed, please state "not working" in the Current Employer, Employer Name field. Sending a resume does not substitute for completing this form. You may send a resume, but this form is required. If the Graduate Program you are applying for requires further experience than this form allows, you may submit additional forms by clicking on the Work Experience Form link again. Be sure to fill out each form completely.

Current Employer

A.	Employer name	Phone
	Address	Human Resources contact
	Nature of business	Job title
	Your status Full time Part time Starting date
	Brief description of your duties
	Is this organization a subsidiary, division or affiliate? If so, list parent company name:
	Are you eligible for full or partial tuition reimbursement through your employer? Yes No

Previous Employers

B.	Employer name	Phone
	Address	Human Resources contact
	Nature of business	Job title
	Your Status Full time Part time Starting date Ending date
	Brief description of your duties

C.	Employer name	Phone
	Address	Human Resources contact
	Nature of business	Job title
	Your status: Full time Part time Starting date Ending date
	Brief description of your duties

D.	Employer name	Phone
	Address	Human Resources contact
	Nature of business	Job title
	Your status Full time Part time Starting date Ending date
	Brief description of your duties