PEOPLE Summer 2014 Undergraduate Application
Middle School & High School
Application Deadline: Monday, March 17th, 2014
Please check all positions you would like to be considered for:
If interested in more than one position, please rank in order of preference (1=Highest Preference)
Middle School Program
3-week TEACHING ASSISTANT position (June 16-July 3, 2014, 7:30am-12:30pm)
5-week TEACHING ASSISTANT position (June 16-July 19, 2014, 7:30am-4:30pm)
High School Program
3-week COUNSELOR position (June 22-July 12, 2014 -Live-in position)
Are you CPR certified? Please check one box: □ Yes□ No
6-week COUNSELOR position (June 22-August 2, 2014 -Live-in position)
Are you CPR certified? Please check one box: □ Yes□ No
Fine Arts Assistant position (Hours Vary)
Office Assistant position (Hours Vary)
Special Events Assistant position (Hours Vary)
Note: There will be a MANDATORY training prior to the start of the summer program. High school counselors are required to
move into the dorms on June 21st, 2014
Your application package must include the following:
1.
2.
3.
4.
Completed application
Unofficial UW-Madison transcript
Resume
500-word essay (if applying for Counselor position)
Incomplete application packets will not be considered.
Please return completed application to:
UW – Madison PEOPLE Program 1305 Linden Drive, Suite 240 Madison, WI 53706
For more information, please contact:
Middle School: Gail Ford gford@cdo.wisc.edu
High School: Tim Annis: tannis@cdo.wisc.edu
*** Applications will be accepted until all positions are filled. ***
Applicant Name: ________________________________________________________________________________
APPLICANT INFORMATION
Last Name
Street Address
City
First M.I.
Apartment/Unit #
State ZIP
Phone #
Date
E-mail Address
Are you at least 18yrs old or older?
Campus ID #
Are you a citizen of the United States? YES
Have you ever worked for PEOPLE? YES
Do you have a valid driver’s license? YES
Language(s) spoken, other than English:
Check one: Male Female
NO If no, are you authorized to work in the U.S.? YES NO
NO If yes, when?
NO
How did you hear about this position?
T-Shirt Size: XS S M L XL XXL
EDUCATION (Please attach recent college transcript.)
Year in School
Declared Major
Are you eligible for work study? YES NO If yes, can you be hired as a
work-study student?
Do you have any vacation plans, internship opportunities, appointments, etc. during the dates of the program?
Anticipated Graduation:
YES
NO
YES
NO
YES
NO
If yes, please list commitments and dates:
Do you plan on taking summer school courses during the dates of the program?
If yes, please list dates and times:
ACTIVITIES & PERSONAL EXPERIENCE
Please list other interests or activities which may qualify you for this position. (Ex. Special certifications, volunteer work, etc.)
Please list your personal experiences or qualities you posses that make you prepared to do well in this position.
P
PREVIOUS EMPLOYMENT (Please list most recent first)
Company
Address
Job Title
Supervisor
Phone #
Responsibilities
From To
Reason for Leaving
May we contact your previous supervisor for a reference? YES
NO
Company
Address
Job Title
Supervisor
Phone #
Responsibilities
From To
Reason for Leaving
May we contact your previous supervisor for a reference? YES
NO
Company
Address
Job Title
Supervisor
Phone #
Responsibilities
From To
Reason for Leaving
May we contact your previous supervisor for a reference? YES
Additional work related experience:
NO
SHORT ESSAY (Complete only if applying for HS Counselor)
The role of a PEOPLE counselor is a unique one and carries a great deal of expectation in terms of assisting and supporting
students in the PEOPLE Program. It will be crucial that the summer counselors are familiar with the needs of culturally diverse
high school students, and well versed in the services offered on campus. Please describe in 500 words or less an experience
that you have had working with youth. Be sure to include the following: A description of your experience – what did you
do? What were some of the challenges you faced? What insight did this experience provide you with? Please conclude
with how you feel your experiences would contribute to your success when working with PEOPLE.
OFFICE SKILLS & SHIFT AVAILIABILITY (Complete only if applying for HS Office Assistant position.)
Shift availability: 1ST SHIFT (7AM–3PM) 2ND SHIFT (3–11PM) 3RD SHIFT (11PM-7AM)
Please rate your Microsoft Office 2010 software experience: 1-low 2-some 3-moderate 4-proficient 5-advanced
Access
Word
Excel
Publisher
Power Point
List other software programs you are proficient in: How many words per minute can you type?
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading
information in my application or interview may result in my termination.
Signature
Date