Student Employment Application

First Name*

Last Name*

Address*

City*

Email Address*

Phone Number*

Do you live on campus?

Yes

No

Are you applying for Workstudy and/or Student Aid?

Work Study

Student Aid

Required. Please select at least one.

What is the amount of work study funds you are eligible for?*

Education

Previous High Schools and/or Colleges Attended, with graduation date

Current JCC Program of Study (Major)*

Full, or part-time status

Full-time (12+ credit hours)

Part-time (6-12 credit hours)

GPA

Anticipated graduation date from JCC

Company Name

Business Address

Job Title

Supervisor's NameWe will not contact the Supervisor without your permission

Business Phone Number

Job Responsibilities

Dates Employed

Reason for Leaving

Professional Reference 1*

Professional Reference 2*

Professional Reference 3*

What skills do you possess that would market your candidacy for various campus jobs?*

Why are you interested in working on campus?*

For certain positions, you may be required to work outside normal business hours (please read job descriptions carefully).

What are your hours of availability?*

Do you have prior commitments that may interfere with working on campus?*

When can you start working?*

Signature*