STUDENT EMPLOYMENT APPLICATION
University of Wisconsin-Stout Library
315 10th Ave E
Menomonie, WI 54751
Name (Last, First, M.I.)
E-mail Address
Student ID Number
Address:
Local Phone
Local Address
Permanent Phone
Permanent Address
Position Applying For (if Applicable)
Available Starting Date (MM/DD/YY)
Will you be available for at least 4 semesters of employment due to extensive training in some jobs?
State Payroll
No
Work Study for $
WORK EXPERIENCE
(Including other UW-Stout Employment)
Most Recent/Current Employer:
Place/Name of Employment
Yes
Unsure
U
n
s
u
r
e
Phone
Dates of Employment
Phone
Dates of Employment
Duties Performed:
Second Most Recent Employer:
Place/Name of Employment
Duties Performed:
THE OTHER SIDE OF THIS APPLICATION MUST BE ENTIRELY FILLED OUT TO BE CONSIDERED FOR EMPLOYMENT
BY SIGNING AND DATING BELOW, I AGREE THAT ALL THE INFORMATION ON THIS APPLICATION IS TRUE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE
Signature:
Date:
The University of Wisconsin-Stout is an equal opportunity/affirmative action institution committed to diversity in its people and programs.
1. Will you be student teaching?
Will you be off campus, unavailable for employment for a quarter or semester?
2. Will you be available evenings and weekends?
3. Will you be available during vacations and breaks?
4. Will you be available at the beginning and end of semesters?
5. Computer and Library Experience
What computer software/programs have you used?
Do you have any previous library experience?
If Yes, please provide a brief description:

Yes







Yes
Yes
Yes
Yes
Yes
Yes






No
No
No
No
No
No

Yes

No
No
6. Would you be able to carry boxes if the position required it?
USING THE TABLE BELOW – USE AN “X” TO INDICATE WHEN YOU HAVE CLASS
OR OTHER COMMITMENTS THAT MAKE YOU UNAVAILABLE TO WORK
HOUR
TIME
Open
7:45-8:00
9:00
1
8:00- 9:05
10:00
2
9:05-10:10
11:00
3
10:10-11:15
noon
4
11:15-12:20
1:00
5
12:20-1:25
2:00
6
1:25-2:30
3:00
7
2:30-3:35
4:00
8
3:35-4:40
5:00
9
4:40-6:00
6:00
10
6:00-7:00
7:00
7:00-8:00
8:00
8:00-9:00
9-12:15am
9pm-12:15am
Monday
Tuesday
Wednesday
Thursday
Friday
TIME
Saturday
Sunday