Office of Financial Aid
P.O. Box
| Thibodaux,
Office
of2005
Financial
Aid LA 70310 | 985.448.4048 | 985.448.4124 [F]
P.O. Box 2005 | Thibodaux, LA 70310 | 985.448.4048 | 985.448.4124 [F]
Student Employment Information Sheet 2016-17
Complete and return this form if you are interested in student employment.
Name: ________________________________
Nicholls ID#: __________________
Check any skills or talents that you possess that would make you a productive student
employee:
q
q
q
q
q
q
q
q
People/Communication Skills
Computer
Typing
Organizational
Filing
Artistic
Bilingual: _____________________
Other Skills: ___________________
List present and previous employment (start with present employer and most recent
position):
Begin
Date
End
Date
Name and Address of Employer
Position
May inquiry be made of your present employer?
q No
q Yes
May inquiry be made of your former employer?
q No
q Yes
Signature: _____________________________________
Date: ___________________
Individuals needing accommodations (ADA) are encouraged to call 985-448-4783 or visit nicholls.edu/ada for assistance.
It is the policy of Nicholls State University not to discriminate on the basis of race, color, sex, national origin, age or disability in
its educational programs, activities or employment practices as required by Title IV and Title VII of the Civil Rights Act of
1964, Age Discrimination in Employment Act of 1967, the Equal Pay Act of 1963, the Americans with Disabilities Act of
1990, Executive Order 11246, Sections 503 and 504 of the Rehabilitation Act of 1973 and Section 402 of the Vietnam Era
Readjustment Assistance Act of 1974.
For Office Use Only
Date: _________ Initials: ______