Housing and Residence Life
Summer Staff Employment Application
Please put an “X” to indicate the Summer Session to which you are applying.
____________________
Summer Session 1
May 31 to July 1
_________________
Summer Session 2
July 10 to August 12
_________________
Summer Session 1 &
Summer Session 2
___________________
All Summer:
May 31 to August 12
(Includes the break between Summer
Session 1 and Summer Session 2)
CANDIDATE INFORMATION
Date of Application:
Last Name:
First Name:
Permanent Address:
Cell Phone Number:
Middle Initial:
Date of Birth:
On Campus Address
Room:
Hall:
KU Email Address:
Student ID Number (9 digits)
@live.kutztown.edu
HR Work Authorization # :
Date of Previous KU Background Check:
Cum. GPA:
# of Completed
Credits:
Previous Housing and Residence Life Experience
Hall/Building
Employment Dates
Position Held
Which Summer Session is the
course offered?
Course(s) to be taken over the summer
Name of Course
# of Credits
PLEASE INDICATE OTHER SUMMER OBLIGATIONS:
Will you have another job on campus during this time? _____
If yes, what other department(s)._________________________________________________________________
NOTE: If hired, this application will remain on file with Housing and Residence Life.
Signature: ______________________________________________Date:_________________________________
Updated: 1/19/2016/MGM