University of West Florida
Human Resources
Application for Student Employment
NAME: ___________________________ ______________________ ___ ___________________
Last First MI Maiden
Present Address: ___________________________ ____________________ ___ ____________
Street City State Zip Code
Telephone: _______________ Cell Phone: ________________
How many hours a week can you work? ____
Days/hours available to work:
Monday _____ Thursday _____
Tuesday _____ Friday _____
Wednesday _____
Date available for work? ______________________
Education:
Type of School: Name of School Number of Years Completed Major/Degree
High School: _______________________ _____ _________________
_______________________ _____ _________________
College: ________________________ _____ __________________
________________________ _____ __________________
________________________ _____ __________________
Work Experience (begin with your most recent job held)
1) Name of Employer: _______________________________________________
Address: ________________________________ ___________________ ____ ________________
Street City State Zip Code
Phone Number: _____________________
Employment Dates: From: _________________ To: ___________________
Name of Supervisor: _______________________________________________
Reason for leaving: ____________________________________________________________________
May we contact employer? _____Yes _____ No
List duties performed, skills used or learned, etc.
Work Experience (continued).
2) Name of Employer: _____________________________________________________________________
Address: ______________________________ _________________________ _____ _______________
Street City State Zip Code
Phone Number: ____________________
Employment Dates: From: __________________ To: _____________________
Name of Supervisor: __________________________________________________
Reason for leaving: ______________________________________________________________________
May we contact employer? _____ Yes _____ No
List duties performed, skills used or learned, etc.
3) Name of Employer: ________________________________________________
Address: _____________________________________ _________________ ____ ____________
Street City State Zip Code
Phone Number: ______________________
Employment Dates: From: _________________ To: ___________________
Name of Supervisor: ________________________________________________
Reason for leaving: ____________________________________________________________________
May we contact employer? _____Yes _____ No
List duties performed, skills used or learned, etc.
Work Experience (continued).
4) Name of Employer: ____________________________________________________________________
Address: ________________________________ __________________________ ____ _________
Street City State Zip Code
Phone Number: __________________
Employment Dates: From: __________________ To: ____________________
Name of Supervisor: ________________________________________________
Reason for leaving: _____________________________________________________________________
May we contact employer? _____ Yes _____ No
List duties performed, skills used or learned, etc.
Applicant Signature: ______________________________________ Date: ____________________
Updated 11/01/2007