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Work Study Employment Application

We Are An Equal Opportunity Employer

We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related medical condition or handicap, or any other legally protected status.


Application
* Indicates a required field

Student Information

First Name:*

Last Name:*

Middle Initial:

Home Street Address:

City:

State:

Zip:

Cell Phone:*

Campus Email:

Date of Birth:

Gender:

Citizenship Status:


Academic Information

Classification:

Cumulative GPA:


Schedule and Hours

Indicate days and times you are available to work

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday


Employment

Positions applying for (see Work Study link on
LC webpage for list of available positions):*


Are you applying as a returning Work Study student?

Have you been requested by a supervisor already?

If yes, Please state the office or name of Supervisor:


Identify all skills you have that would make you a candidate for the Federal Work Study program. (For example: typing, speaking on the phone, knowledge of a foreign language etc.). This is an important component that supervisors will look at when choosing candidates to interview.


Work Experience

Work Experience - List most recent first.

Name and Location:

Dates of Employment:

Supervisor Contact Information:


Name and Location:

Dates of Employment:

Supervisor Contact Information:


Please list ONE additional reference who is not a previous employer. These may be individuals on campus (i.e: instructors, coaches, advisors, etc.) Please do not list fellow students or the supervisor for the position you are applying for as your reference.

Name:*

Position/Relation:*

Phone:*


Title: