Idaho State University

Personal Information

Student ID Number:
Last Name:
First Name:
Date of Birth (mm/dd/yyyy):
Campus Phone:
Cell Phone:
Email Address:
Cumulative GPA:
Current Semester Credit Hours:
Next Semester Credit Hours:

Campus Address

Street Address:
City:
State or Country:
Zip Code:

Permanent Address, if different from Campus Address

Street Address:
City:
State or Country:
Zip Code:

Availability

Can you commit for one year? Yes No

If no, why?

Are you eligible for work study? Yes No

If yes, how many hours?

Specify and prioritize by placing a number in the blank next to the position(s) you wish to apply for (Example: 1st request=1, 2nd request=2)

Resident Assistant*
Building Manager*
Office Assistant
Desk Assistant
Custodial Assistant
Conference Assistant
Safety Assistant
Paint Crew

*Resident Assistant and Building Manager applications should only be filled out in late November and early December of each year for the following academic year.

Previous Work Experience: List Most Recent First

Job Title
Date
Supervisor
Phone
Job Title
Date
Supervisor
Phone
Job Title
Date
Supervisor
Phone
Job Title
Date
Supervisor
Phone

Extra curricular activities:

Work experience related to position you are applying for: