OFFICE USE ONLY
APPALACHIAN STATE UNIVERSITY Date Received: __________________
UNIVERSITY RECREATION
Date Emailed: ___________________
Application for Employment
Active Until: _____________________
Date of Application: Initial: __________________________
Position applying for:
Please Circle the Semester Applying for: Fall Spring Summer#1 Summer#2
I. PERSONAL INFORMATION
Name:
Last First Middle
E-Mail Address: ASU Box Number:
Local Address: Local or Cell Telephone #: ( ) __________
Street & Apt. # / Residence Hall and Room #:
City / State / Zip Code:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Permanent Address: (Parent/Guardian Address) Parent/Guardian Home Telephone #: ( ) __________
Street & Apt. # / P.O. Box:
City / State / Zip Code:
Classification: FR__ SO__ JR__ SR__ Grad.__
Major: Expected Graduation Date:
Please list any injury, illness or medical condition, which might require treatment:
II. WORK EXPERIENCE:
Position Company/Organization Length of Employment Supervisor:
Phone:
Position Company/Organization Length of Employment Supervisor:
Phone:
Position Company/Organization Length of Employment Supervisor:
Phone:
III. CERTIFICATION(S): (i.e. CPR, First Aid, Group Fitness, Personal Training . . .):
***PLEASE ATTACH RESUME IF AVAILABLE OR A LIST OF QUALIFICATIONS AND REFERENCES (including email
address)
University Recreation is an Equal Opportunity Employer. It is our policy to make all personnel decisions without discriminating on
the basis of race, color, creed, religion, sex, physical disability, mental disability, age, marital status, sexual orientation, citizenship
status, national or ethnic origin, and any other protected status.
Name: Date:
Minimum # of hours you are requesting: Maximum # of hours you are requesting:
The following availability is for (Please Circle): Fall Spring Summer#1 Summer#2
Please check the times below that you ARE AVAILABLE to work each day:
Time Mon Tue Wed Thu Fri Sat Sun
5:30 am
6:00 am
6:30 am
7:00 am
7:30 am
8:00 am
8:30 am
9:00 am
9:30 am
10:00 am
10:30 am
11:00 am
11:30 am
12:00 pm
12:30 pm
1:00 pm
1:30 pm
2:00 pm
2:30 pm
3:00 pm
3:30 pm
4:00 pm
4:30 pm
5:00 pm
5:30 pm
6:00 pm
6:30 pm
7:00 pm
7:30 pm
8:00 pm
8:30 pm
9:00 pm
9:30 pm
10:00 pm
10:30 pm
11:00 pm
11:30 pm
12:00 am
12:30 am
Please attach Class Schedule