Student Employee Job Application

Personal Data:

Name:

Date:

Phone Number:

Email:

Student ID:

Local Address:

Do you qualify for Federal Work-Study?YesNo

Are you currently enrolled at BHSU?YesNo

Major:

Estimated Completion Date:

Are you or have you previously been employed at BHSU? If yes, where?

Work History

List employment history including company name, address, telephone number, the position held, and dates of employment.

References: (Please list persons that we may contact regarding your work experience.

Please list any experience that you have had with computers, computer programming, or any other relevant experience which would qualify you for a job at the computer center.