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Student Employment Application Form

Applicant Information
Full Name: (Last, First, M.I.)
Address: Street:     
City:         
State:           Zip:
Phone:
Email:
Date Available:
Times Available: Monday:      
Tuesday:     
Wednesday:
Thursday:    
Friday:         
Student's 900#:
Are you a Citizen of the United States?


If no, are you authorized to work in the U.S.?


Have you ever been convicted of a felony?


If yes, explain:

 
Which job are you applying for?

 
   

Education
Do you plan to attend classes at Auraria Campus for the next two semesters?


Major:
Projected Graduation Date:
Credits this semester:
Were "College Work Study" funds awarded to you?

| Amount:

School:



Class:




   

References
Please list three professional/personal references. May we contact your references?


Full Name:
Relationship:
Company:

Phone:

   
Full Name:
Relationship:
Company:
Phone:
   
Full Name:
Relationship:
Company:
Phone:
   

Skills
List all related knowledge and skills you bring to this job:
Computer skills:


Please list software knowledge:
Typing/data entry:


Customer service:


   

Previous Employment
Company:
Phone:
Address: Street:   
City:       
State:          Zip:
Supervisor:
Job title:
Starting salary:
Ending Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?


   
Company:
Phone:
Address: Street:
City:    
State:       Zip:
Supervisor:
Job title:
Starting salary:
Ending Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?


   
Company:
Phone:
Address: Street:  
City:      
State:         Zip:
Supervisor:
Job title:
Starting salary:
Ending Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?


Disclaimer
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 release.