Lehigh Athletics

Summer Camps

Employment Information

This webpage will assist you in providing Lehigh with all the necessary information to work at our summer sport camps. If you experience problems or have any questions, please contact Greg Strobel at (610)758-3589.

1) Have you been hired as a FULL TIME Lehigh University employee WITHIN the least 2 years?

Yes
No

2) During camp, will you be staying overnight on campus in housing provided by the camp?

Yes
No

BACKGROUND CHECK NOTIFICATION & CONSENT

Disclosure, Authorization and Consent for Pre-Employment Screening Report

In connection with my application for employment at Lehigh University, I hereby authorize the Employer and any agent it authorizes to perform a pre-employment background screening check (including future screenings for retention, promotion, or re-assignment, if applicable, unless revoked in writing). I understand that the employer may obtain a credit report, which consists of information having a bearing on job performance, and may include information from public and private sources, public records, courts, schools, former employers, and references concerning my driving record, court records, credit, worker’s compensation record, education, credentials, identity, and previous employment.

Under the Fair Credit Reporting Act, should an employer rely upon a consumer report from a Consumer Reporting Agency in taking an adverse action regarding employment, before taking that action I will be provided with a copy of the Consumer Report and a summary of rights. Upon written request to any Consumer Reporting Agency, I may obtain a copy of my report as provided by law.

I authorize and release people, companies, references, current and former employers, schools, credit bureaus, municipal, county, state, and federal agencies and courts, to provide all information that is released to the employer or its authorized agents. I further release and hold harmless all of the above, including the employer, to the full extent permitted by law, from any liability or claims arising from retrieving and reporting of information concerning me. I agree that a copy or fax of this document shall be as valid as the original.

I certify that the information on my application and accompanying documents is true and correct. I understand that any misrepresentation or omission of facts may be considered as cause for rejection of my application or termination of employment at any given time. I understand that nothing contained in this employment application and accompanying forms, or in the granting of an interview, is intended to create an employment contract between Lehigh University and me for either employment or for the provision of any benefit. No promises regarding employment have been made to me. If an employment relationship is established, I understand I have the right to terminate my employment at any time and that Lehigh University retains a similar right to terminate the employment relationship at any time with or without cause.

I authorize Lehigh University to verify all information contained in this application and any supplement hereto. I hereby release Lehigh University, employers, schools, or persons from all liability as the result of inquiries based on information contained in my application or connected with the hiring process.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) is designed to promote accuracy, fairness, and privacy of information used in the process of granting credit. This information is supplied by public record sources, credit grantors and others to credit reporting agencies (CRA’s) who organize and store that information for distribution to credit grantors, employers and insurers who are making credit, employment and insurance decisions about you. The FCRA gives suppliers and users of credit information, and CRA’s, specific responsibilities in connection with their respective roles in the credit granting and reporting process. The FCRA also gives you specific rights in dealing with these entities, as summarized below. You can find the complete text of the FCRA, 15 U.S.C. 1681 et seq., at the Federal Trade Commission’s web site (http://www.ftc.gov). You may have additional rights under state law. You may contact a state or local consumer protection agency or a state attorney general to learn those rights.

  • Access to your file is limited. Your file may only be accessed by those who have a permissible purpose recognized by the FCRA-usually to consider an application you have submitted to a creditor, insurer, employer, landlord, or other business, or to consider you for an unsolicited offer of credit.
  • Your consent is required for reports that are provided to employers or that contain medical information. A CRA may not give a report about you to your employer, or prospective employer, without your written consent. A CRA may not report medical information about you to creditors, insurers, or employers without your permission.
  • You can find out what is in your file. Upon your request, a CRA must give you all the information in your file, and a list of everyone who has requested it recently. However, you are not entitled to any information concerning “risk scores”, ”credit scores”, or other economic predictors that are in your file. There is no charge for the report if a third party used the information in your file to take unfavorable action toward you and you request the report within 60 days of receiving notice that the information in your file was used by a third party unfavorably. You are also entitled to one free report every twelve months upon request if you certify that (1) you are unemployed and plan to seek employment within 60 days, (2) you are on welfare, or (3) your report is inaccurate due to fraud. Otherwise, a CRA may charge you a fee of up to eight dollars.
  • You must be told if information in your file was a factor considered by a third party who took unfavorable actions toward you. Upon your request, anyone who considers information from a CRA and who takes unfavorable action towards you—such as denying an application for credit, insurance, or employment—must give you the name, address, and phone number of the CRA that provided the information. Keep in mind that the third party, not the CRA, took the unfavorable action toward you and that the CRA will not be able to provide you with the reason for the unfavorable action.
  • You can dispute inaccurate information with the CRA. If you tell a CRA that your file contains inaccurate information, the CRA must reinvestigate the items (usually within 30 days) by presenting to its information source all relevant evidence you submit, unless your dispute is frivolous. The source must review your evidence and report its findings to the CRA. (The source also must advise national CRA’s—to which it has provided data—of any error.) The CRA must give you a written report of the investigation, and a copy of your report if the investigation results in any change. If the CRA’s investigation does not resolve the dispute, you may add a brief statement to your file. The CRA must normally include a summary of your dispute statement in future reports. If an item is deleted or a dispute statement is filed, you may ask that anyone who has recently received your report be notified of the change.
  • Inaccurate information must be corrected or deleted. A CRA must remove inaccurate information from its files, usually within 30 days after you dispute it. However, the CRA is not required to remove accurate data from your file unless it is outdated (as described below) or cannot be verified. If your dispute results in any change to your report, the CRA cannot reinsert into your file a disputed item unless the information source verifies its accuracy and completeness. In addition, the CRA must give you a written notice telling you it has reinserted the item. The notice must include the name, address, and phone number of the information source.
  • You can dispute inaccurate items with the source of the information. If you tell the third party who furnished information to a CRA—such as a creditor who reports to a CRA—that you dispute an item, it may not then report the information to a CRA without including a notice of your dispute. In addition, once you’ve notified the source of the error in writing, it may not continue to report the information if it is, in fact, an error.
  • Outdated information may not be reported. In most cases, a CRA may not report negative information that is more than seven years old (ten years for bankruptcies).
  • You may choose to exclude your name from CRA lists for unsolicited credit and insurance offers. Creditors and insurers may use file information as the basis for sending you unsolicited offers of credit or insurance. Such offers must include a toll-free telephone number for you to call and tell the CRA if you want your name and address removed from future lists or offers. If you notify the CRA through the toll-free number, it must keep you off the lists for two years. If you request, complete and return the CRA form provided for this purpose, you can have your name and address removed indefinitely.
  • You may seek damages from violators. If a CRA, a user or (in some cases) a provider of CRA data, violates the FCRA, you may sue them in state or federal court.
The FCRA gives several different federal agencies the authority to enforce the FCRA:
FOR QUESTIONS OR CONCERNS REGARDING: PLEASE CONTACT:
CRAs, creditors and others not listed below Federal Trade Commission
Bureau of Consumer Protection - FCRA
Washington, DC 20580
202-326-3761
National banks, federal branches/agencies of foreign banks (word “National” or initials “N.A.” appear in or after bank’s name) Office of the Comptroller of the Currency
Compliance Management, Mail Stop 6-6
Washington, DC 20219
800-613-6473
Federal Reserve System member banks (except national banks, and federal branches/agencies of foreign banks) Federal Reserve Board
Division of Consumer & Community Affairs
Washington, DC 20551
202-452-3693
Savings associations and federally chartered savings banks (word “Federal” or initials “F.S.B.” appear in federal institution’s name) Office of Thrift Supervision
Consumer Programs
Washington, DC 20552
800-842-6929
Federal credit unions (words “Federal Credit Union” appear in institution’s name) National Credit Union Administration
1775 Duke Street
Alexandria, VA 22314
703-518-6360
Banks that are state-charted, or are not Federal Reserve System members Federal Deposit Insurance Corporation
Division of Compliance & Consumer Affairs
Washington, DC 20429
800-934-FDIC
Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission Department of Transportation
Office of Financial Management
Washington, DC 20590
202-366-1306
Activities subject to the Packers and Stockyard Act,1921 Department of Agriculture
Office of Deputy Administrator - GIPSA
Washington, DC 20250 *202-720-7051
I have read and give consent to the screening report described above, and I have also read and understand the disclosure of my rights under the Fair Credit Reporting Act

3) Are you going to be hired as either a guest speaker or a volunteer?

Yes
No

4) Have you received a paycheck from Lehigh University within the past 6 months?

Yes
No

We are required to notify you of our Workers Compensation program and your rights within that program. Please download and read the following two documents:

  • LU Healthcare Provider Panel & Procedures
  • LU Employee Notification Acknowledgement

Everyone needs to download, print, complete, & BRING with them to the first day of camp the following:

  • W4 Form
  • I9 Employement Verification Form
  • Residency Certification Form

You will also be asked to show adequate identification upon arrival at camp. We will make photocopies of these documents for our files. You must present the ORIGINAL document for review. Examples of adequate ID are:

  • Drivers License AND Original Social Security Card
  • Drivers License AND Original Birth Certificate
  • Passport

For more information on acceptable forms of ID, please view the instructions provided with the I9 Employment Verification form listed above.

I understand the above two documents regarding Workers Compenstation at Lehigh. I also agree to complete and bring my W4 and I9, as well as bring acceptable forms of identification to the first day of camp.

Contact/Personal Information
First Name
Middle Name
Last Name
Name Suffix Example: Jr, III...
Address
Address 2
City
State
Zip/Postal Code
Work Phone Example: 6107583000
Home Phone
Cell Phone
Email
Social Security # Example: 123456789 (we require this information for payroll purposes and to conduct a background check if required)
Lehigh Id Number Example: 823456789 (if you are a Lehigh student or employee this information is needed for payroll purposes)
Date of Birth mm/dd/yyyy
What job will you be performing? (check all that apply)













Which camp(s) will you be working? (check all that apply)





















What certifications do you have? (check all that apply)

Enter your certification number -




Enter your PA ATC number -

Are/Have you/Do you have... (check all that apply)



Please Explain (Note that a conviction will not necessarily disqualify you from the job for which you have been hired):

What is your current status/position? (check all that apply)



Enter the name of your current place of employment -







Enter the name of the school you currently attend -