Human Resources – Division of Student Affairs
Burruss Hall, Suite 113 (0923), 800 Drillfield Drive - Blacksburg, VA 24061
Phone: (540) 231-2784 Fax: (540) 231-1998 Web: www.dsa.vt.edu
Division of
Student Affairs
Please note: This form MUST be attached to the online application to be considered an applicant for Dining Services.
STUDENT NAME:
LAST
FIRST
HOURS AVAILABLE / WEEK:
MIDDLE INITIAL
CLASS YEAR (1 2 3 4 5 G):
MAJOR:
WHERE DO YOU WANT TO WORK? Type a number in the yellow box beside the name of the dining
center you want to work at. 1 being your 1st choice, 2 being 2nd choice, 3 being 3rd choice, etc. If no preference,
put an “X” in the “ANY” category.
Deet’s Place
D2 / DX
Southgate
Squires / GLC /
Goodwin Hall
Hokie Grill
Owens
Food Court
Personal
Touch Catering
Turner Place
West End
Market
ANY
WHEN CAN YOU WORK? Please indicate the times when YOU ARE AVAILABLE to work based on your
class schedule and commitments. Double click the gray box and select “Checked” in Default Value then click “OK” to
indicate when you can work.
Early AM
2am-7am
Morning
7am-11am
Lunch
11am-2pm
Afternoon
2pm-4pm
Evening
4pm-8pm
Night
8pm-11pm
Late Night
11pm-2am
Unknown/
Schedule
Not Set
MON
TUE
WED
THUR
FRI
SAT
SUN
Notes / Additional Information:
Please note: This form MUST be attached to the online application to be considered an applicant for Dining Services.
Rev 8/12