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Application for student Employment

Date: 2013-05-23

Jobs Listing

* Required Fields

Job(s) applying for:

Applicants may apply for a maximum of 5 positions.

Your First choice position1.

Your Second choice position2.

Your Third choice position3.

Your Fourth choice position4.

Your Fifth choice position5.

PERSONAL INFORMATION

Name:

* Last/Family Name	* First/Given Name	Middle Initial	Preferred Name
Permanent Address:

* Permanent Street Address	* Permanent City Address	* Permanent State Address	* Permanent ZIP Address
* Permanent Phone:
Local Address (if different from permanent address):

Street	City	State	ZIP
* Local Phone:

If a student, Unity ID:		* Email address:

EQUAL OPPORTUNITY INFORMATION -- VOLUNTARY DEMOGRAPHIC DATA

Equal Opportunity information is VOLUNTARY.

Discrimination on the basis of race, sex, color, creed, religion, national origin, age, disability or veteran status is prohibited at NC State University. Sex or age or absence of a disability may be a bonafide occupational requirement in a small number of jobs. The information requested below will not affect you as an applicant. The information will be retained to ensure that the University's recruitment efforts are reaching all segments of the population.

NC State University regards discrimination of the basis of sexual orientation to be inconsistent with its goals of providing a welcoming work environment in which all of its students, faculty, and staff may learn and work up to their full potential. The University values the benefits of cultural diversity and pluralism in the academic community and welcomes men and women of good will without regard to sexual orientation.

Gender:

Gender: Female

Gender: Male

Gender: Do Not Wish To Disclose

Ethnic Group:

Ethnic Group: White
Ethnic Group: Black / African American (non-Hispanic)
Ethnic Group: Hispanic / Latino
Ethnic Group: Asian
Ethnic Group: American Indian
Ethnic Group: Hawaiian or Pacific Islander
Ethnic Group: Do Not Wish To Disclose

Date of Birth:

Month of Birth Day of Birth Year: of Birth

GENERAL INFORMATION

* Do you have a work study award?
No, I do not have a work study award.	Yes, I have a work study award.		If Yes, list the amount per semester.

			$ If Yes, list the amount for the fall semester.	$ If Yes, list the amount for the spring semester.	$ If Yes, list the amount for summer session 1.	$ If Yes, list the amount for summer session 2.
			Fall	Spring	SS I	SS II

* Are you now employed or have you ever been employed by the NCSU Libraries?
No, I am not currently and have not been previously employed by the NCSU Libraries.	Yes, I am currently or have been previously been employed by the NCSU Libraries.	If Yes, list department, dates, and name used (if different from above).

* Have you ever been convicted of an unlawful offense other than a minor traffic violation?
No, I have never been convicted of an unlawful offense other than a minor traffic violation?	Yes, I have been convicted of an unlawful offense other than a minor traffic violation?	If Yes, please explain. (A "Yes" will not automatically disqualify you.)

AVAILABILITY

Date available to start work: (mm/dd/yy)
Number of hours/week you wish to work?

Many jobs can be scheduled to meet your needs.

When are you available to work?

	Morning	Afternoon	Evening	Overnight	Time you are available
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

EDUCATION

* Did you graduate from high school?	No, I did not graduate from high school. Yes, I graduated from high school.
* Did you graduate from college?	No, I did not graduate from college. Yes, I graduated from college.
Type of degree: (college)
* Did you graduate from graduate school?	No, I did not graduate from graduate school. Yes, I graduated from graduate school.
Type of degree: (graduate)

* Are you now a student?	No, I am not currently a student. Yes, I am currently a student.
If a student, are you part or full time?	I am a Part time student. I am a Full time student.
If a student, what type?	I am a Undergraduate student. I am a Graduate student. I am a Other type of student.
If a student, what is your major field of study?

SKILLS

Areas in which you have training or experience. Check all that apply.

I have training or experience in Audio/Visual Equipment
I have training or experience in Bookkeeping/Accounting
I have training or experience in Customer/Public Service
I have training or experience in Data Entry/Keyboard
I have training or experience in General Office
I have training or experience in Heavy Lifting
I have training or experience in Photocopy Equipment
I have training or experience in Computing Skills - applications, programs, and languages:

Please list any applicable applications, programs, or languages

I have training or experience in Languages other than English - list language(s):

Please list any languages other than English.

I have training or experience in Other - list:

Please list any other training or experince.

OTHER QUESTIONS

* Why are you interested in working for the NCSU Libraries?

EMPLOYMENT/VOLUNTEER WORK HISTORY
List most recent employer first.

Employer:
Address:

Date Employed (mm/yy):
Date Separated (mm/yy):

Supervisor's Name:
Telephone Number:

Reason for Leaving:	Duties:
Other comments:

Employer:
Address:

Date Employed (mm/yy):
Date Separated (mm/yy):

Supervisor's Name:
Telephone Number:

Reason for Leaving:	Duties:
Other comments:

Employer:
Address:

Date Employed (mm/yy):
Date Separated (mm/yy):

Supervisor's Name:
Telephone Number:

Reason for Leaving:	Duties:
Other comments:

North Carolina State University is dedicated to equality of opportunity within its community. Accordingly, North Carolina State University does not practice or condone discrimination in any form against students, employees, or applicants on the grounds of race, color, national origin, religion, sex, age, or handicap. North Carolina State University commits itself to positive action to secure equal opportunity regardless of those characteristics.

I certify that I have given true, accurate and complete information on this form and any supplements. I authorize educational institutions, associations, registration and licensing boards and others to furnish whatever detail is available concerning my qualifications. I authorize investigation of all statements made in this application and I understand that false information or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action or dismissal if I am employed, and/or criminal action/ I further understand that dismissal upon employment shall be mandatory if fraudulent disclosures are given to meet position qualifications. Not withstanding any provision of State or Federal law, I expressly waive any right I may have to review material or information received from a previous employer or educational institution under promise of confidentiality.