Application for Student Worker Position

Applicant Information(Required)

First Middle Last

Home address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

HLGU student email(Required)

Date available(Required)

Class status(Required)

FR

SO

JR

SR

Major(Required)

Position applied for(Required)

Are you a citizen of the United States?(Required)

Yes

No

Did you receive Federal Work Study Approval with your FAFSA?(Required)

Yes

No

Have you ever worked for the University?(Required)

Yes

No

CGPA(Required)

Are you on academic and/or disciplinary probation?(Required)

Yes

No

List extra-curricular interests

References

Please list three references

Full name

First Last

Title

Relationship

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Full Name

First Last

Title

Relationship

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Full Name

First Last

Title

Relationship

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous Employment

Employer

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor

Job title

Responsibilities

Employed from: (month/year)

To: (month/year)

Reason for leaving

Employer

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor

Job title

Responsibilities

Employed from: (month/year)

To: (month/year)

Reason for leaving

Employer

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor

Job title

Responsibilities

Employed from: (month/year)

To: (month/year)

Reason for leaving