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ADMINISTRATIVE OFFICE OF THE STUDENT
UNION BUILDING/CAMPUS LIFE
STUDENT
EMPLOYMENT APPLICATION |
| Please TYPE or PRINT clearly.
Incomplete applications will not receive full consideration.
Please attach cover letter and resume |
| Return Completed
Application to the Student Union Building, Room
240. |
| Position(s) Applying For:
Use scale 1-3, with 1 being
most
desirable, to prioritize. |
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Information Booth Attendant |
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Office Assistant |
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Game Room Attendant |
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| NAME (first) |
(last) |
(MI) |
| Preferred First Name (if
different) |
| SOCIAL SECURITY NUMBER: |
DATE OF
BIRTH: |
| PRESENT ADDRESS |
SUMMER ADDRESS |
PERMANENT ADDRESS |
| _________________________ |
_________________________ |
_________________________ |
| _________________________ |
_________________________ |
_________________________ |
_________________________
(Telephone
Number) |
_________________________
(Telephone
Number) |
_________________________
(Telephone
Number) |
| Summer Work/Other Telephone
Numbers |
| E-Mail Address |
| Current Classification |
![]() Fresh |
Soph |
Jr |
Sr |
Grad |
Transfer |
| Total Hours Enrolled (for this
semester_____) |
P-Time |
F-Time |
| United States Citizen: |
Yes |
No |
Major |
| Is Cumulative GPA greater than 2.0? |
Yes |
No |
Exp Grad
Date |
| Work Experience (Paid/Voluntary):
Resumes may be attached. |
| Company |
Duties
|
| Job Title |
| Company |
Duties
|
| Job Title |
| Company |
Duties
|
| Job Title |
| List Computer and Other Skills: |
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PERSONAL DATA
| Check one: |
Male |
Female |
| Native Language |
| Languages fluently spoken other than native
language |
| |
| List Organizations In Which You Are
Affiliated |
| |
| In case of an emergency, contact: NAME
_________________________________________Phone___________ |
| Have you ever been employed with another CSU
Department? ___________ YES ____________NO |
| If yes, please list |
| What is your expected pay rate/per
hour? |
| List three references that can be
contacted: |
| NAME |
COMPANY/POSITION |
RELATIONSHIP |
PHONE NUMBER |
| ___________________ |
___________________ |
___________________ |
___________________ |
| ___________________ |
___________________ |
___________________ |
___________________ |
| ___________________ |
___________________ |
___________________ |
___________________ |
| List Hours Between 8am and 1am that you expect to be
available to work (indicate preferences with an asterisk): |
| MONDAY |
| TUESDAY |
| WEDNESDAY |
| THURSDAY |
| FRIDAY |
| SATURDAY |
| SUNDAY |
| Number of hours you prefer to work each week |
MINIMUM |
MAXIMUM |
| By my signature, I authorize
verification of all information recorded on this application, including
information pertaining to my academic performance. I also agree to attend
all required training sessions and adhere to the policies and procedures
of the department and University. |
| SIGNATURE OF APPLICANT |
DATE |
| For Office Use
Only: |
| Date Interviewed: |
Interviewed By: |
| Date Hired: |
Starting Pay Rate: |
| Position Placement: |
Employment Termination
Date: |
revised 8/21/02
studappform
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