Student Employment Application
Job Title:
Applicant Information
First Name:
Middle Name:
Last Name:
Student ID#:
Intended Major:
Street Address:
City:
State (enter NA if a non US
address:)
Zip Code:
Home Telephone:
Cell Telephone:
Email Address :
Have you been awarded a State or Federal Work-Study award for the current academic year?:
On Campus Work Experience
Have you ever worked on campus before?:
If yes, please list the Department, Supervisor and their Phone
Number, and a Summary of Job Duties:
Off Campus Work Experience
Most Recent Employer:
Position Title:
Employment Begin Date:
Employer:
Supervisor:
Employment End Date:
Position Title:
Employment Begin Date:
Supervisor:
Employment End Date:
Supervisor's Phone Number:
Summary of Job Duties:
Supervisor's Phone Number:
Summary of Job Duties:
Skills and Qualifications
Please summarize any work-related skills or qualifications acquired from employment or other experience (This includes coursework
completed in related fields such as Psychology, Sociology, Education, etc.):
Campus and Community Involvement
What UST clubs and organizations are you currently involved in?: Please summarize any volunteer work currently or recently
involved in:
Availability
Sunday:
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Total HoursWeek you are
available to work:
When are you able to start?:
Agreement
I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this
information is grounds for dismissal.
BY SIGNING BELOW, I certify that I have read and agree with these statements.
Applicant's Name
Applicant's Signature
Date