Student Worker Application

* Indicates Required Fields

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College Work Study: Deanship Workship: Other:

 

* Fall: Spring: Summer:

 

, weekends or overnights (11pm to 7am) ?

 

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If YES, explain:

 

* Skills:

 

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Name Mailing Address and Phone Number Occupation Association with You
       
       
       

 

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  Name of Institution Address, City, St, Zip Graduation Date
High School/GED      
Vocational/Tech. School      
College/University      

 


 

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First Employer: Telephone:
Address: Pay Rate:
Job Title and Duties: Employed (month and year):
Name of Supervisor: Reason for leaving:

May we contact?

 


 

Second Employer: Telephone:
Address: Pay Rate:
Job Title and Duties: Employed (month and year):
Name of Supervisor: Reason for leaving:

May we contact?

 


 

Third Employer: Telephone:
Address: Pay Rate:
Job Title and Duties: Employed (month and year):
Name of Supervisor: Reason for leaving:

May we contact?

 

What type of tasks would you be interested in performing (mark all that apply)?

 Making webpages  Fixing Computers
 Selling Computers  Installing Computers
 Phone Technical Support  Face-to-Face Technical Support
 General Office Work  Other: