Name

First Name:

Last Name:

Contact Information

Street Address:

City:

State:

Zip:

Residence: On Campus Off Campus

Daytime Phone Number (xxx-xxx-xxxx):

Email Address:

School Information

Student ID Number (xxx-xx-xxxx):

Select your status:
Freshman Sophomore Junior Senior

Major:

Minor:

GPA:

Are you eligible for work-study?

Yes No

Job Information

For which position are you applying?

List hours and days of availability:

List previous work experience beginning with most recent employer, address, telephone # and name of supervisor (please feel free to cut and paste required text from your resume):

List all current co-curricular activities in which you are involved:

Why does employment with the Student/University Center interest you?

Explain what quality customer service means to you:

How did you learn about the Student-University Center?
Referal Job Posting Other

If other, please specify: