STUDENT ASSISTANT APPLICATION · 2020. 8. 13. · Student ID: W_____ STUDENT ASSISTANT APPLICATION...
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Student ID: W_____________ STUDENT ASSISTANT APPLICATION Instructions • To apply, you must be enrolled in a minimum of 6 units in Los Rios CCD (12 units for international students). • Submit one application per position. Multiple positions listed on one application CANNOT be processed. • If applying for a Federal Work Study position, attach copy of FWS Eligibility Letter or Financial Aid Award Summary. • Applications that are not typed or include note of "see resume" will not be accepted. Job Title: __________________________ Department: __________________________ Personal Information Last Name: _________________________ First Name: ____________________________________ Address: ______________________________________________________________________ City: ____________________________ State: ______ Zip Code: ___________ Phone Number: _____________________ Email: ___________________________________ YES NO Major: ______________________________________ Academic Information Is this your 1st semester? Units currently taking: ________ GPA: ______ (if 1st semester, leave blank) Units completed: ________ Skills Computer skills:_________________________________________________________________________ Other skills, certificates, training, languages, or courses completed that are relevant to the position: _____________________________________________________________________________________ _____________________________________________________________________________________ Diversity and Equity Statement How has your experience prepared you to support & promote racial equity and inclusion in your community, school, or work environment? Work Experience List your work history below, beginning with the most recent. If no previous work experience, list any unpaid/volunteer positions. Employer/Company Name: Job Title: From: To: ______________________________ _______________________ _______ - _______ Job Duties & Responsibilities:
Transcript of STUDENT ASSISTANT APPLICATION · 2020. 8. 13. · Student ID: W_____ STUDENT ASSISTANT APPLICATION...
Student ID: W_____________
STUDENT ASSISTANT APPLICATION Instructions • To apply, you must be enrolled in a minimum of 6 units in Los Rios CCD (12 units for international students).• Submit one application per position. Multiple positions listed on one application CANNOT be processed.• If applying for a Federal Work Study position, attach copy of FWS Eligibility Letter or Financial Aid Award Summary.• Applications that are not typed or include note of "see resume" will not be accepted.
Job Title: __________________________ Department: __________________________
Personal Information
Last Name: _________________________ First Name: ____________________________________
Address: ______________________________________________________________________
City: ____________________________ State: ______ Zip Code: ___________
Phone Number: _____________________ Email: ___________________________________
YES NO Major: ______________________________________ Academic Information Is this your 1st semester?
Units currently taking: ________ GPA: ______ (if 1st semester, leave blank) Units completed: ________
Skills
Computer skills:_________________________________________________________________________
Other skills, certificates, training, languages, or courses completed that are relevant to the position: _____________________________________________________________________________________
_____________________________________________________________________________________
Diversity and Equity Statement How has your experience prepared you to support & promote racial equity and inclusion in your community, school, or work environment?
Work Experience List your work history below, beginning with the most recent. If no previous work experience, list any unpaid/volunteer positions.
Employer/Company Name: Job Title: From: To: ______________________________ _______________________ _______ - _______ Job Duties & Responsibilities:
Employer/Company Name: Job Title: From: To: ______________________________ _______________________ _______ - _______ Job Duties & Responsibilities:
Check EACH box to show your AVAILABILITY Which term FALL SPRING SUMMER (check one)
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Additional information regarding your availability: ____________________________________ _____________________________________________________________________________
REFERENCES: List two people who can speak highly of your skills, abilities, and work ethic. (example: supervisors, counselors, teachers, co-workers, community leaders, mentor, etc…NOT family members)
Name: _________________________________ Relation to Applicant: _________________________
Phone: _________________________________ Email Address: _______________________________
Name: _________________________________ Relation to Applicant: _________________________
Phone: _________________________________ Email Address: _______________________________
on the basis of race, color, gender, religion, disability, or national origin. Statement of Policy: No persons may be discriminated against or excluded from any forms of benefits, employment, or activities
*I certify that the information provided on this application is correct and completed to the best of my knowledge.
Signature: __________________________________________ Date: _________________
FOR OFFICE USE ONLY This application has been reviewed by Career Center: YES If this is a FEDERAL WORK STUDY position, is a FWS eligibility letter or financial aid award summary attached:
NO YES
Career Center Verification and initials:
Date:
Note: Completed applications are forwarded to the appropriate division where they are screened. The division will notify those students selected to be interviewed.
