Applicant Information

Applicant Information

Full Name: / Date:
Last / First / M.I.
Address:
Street Address / Apartment/Unit #
City / State / ZIP Code
Phone: / () / E-mail Address:
Expected Graduation Date / Tech ID: / Major/Minor :
Position Applying for:
How long will you be available for this position? / How many hours per week can you work?
Are you available to work
Winter Break / YES / NO / Spring Break / YES / NO
Summer Break / YES / NO / Interim
( between semesters) / YES / NO

Education

College: / City/State:
From: / To: / Did you graduate? / YES / NO / Degree:
Other: / City/State
From: / To: / Did you graduate? / YES / NO / Degree:

References (three people not related to you who can be contacted regarding your qualifications, work habits, and character)

Full Name: / Relationship:
Company: / Phone: / ()
Address: / Email
Full Name: / Relationship:
Company: / Phone: / ()
Address: / Email
Full Name: / Relationship:
Company: / Phone: / ()
Address: / Email

Qualifications

Please list any qualification you have which are related to this position (skills, computer hardware or software, hobbies, interests, languages, research, licenses, etc.

Previous Employment

Employer: / Phone: / ()
Address: / Supervisor:
Job Title:
Responsibilities:
From: / To: / Reason for Leaving:
Employer: / Phone: / ()
Address: / Supervisor:
Job Title:
Responsibilities:
From: / To: / Reason for Leaving:
Employer: / Phone: / ()
Address: / Supervisor:
Job Title:
Responsibilities:
From: / To: / Reason for Leaving:

Schedule (please indicate hours that you are available to work)

Day / Morning / Afternoon / Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Signature

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my dismissal.
Signature: / Date:
If completing this form electronically, please type your name to agree to the terms above.

A member of the Minnesota State Colleges and Universities System. Minnesota State University, Mankato is an Affirmative Action/Equal Opportunity University.

This document is available in alternative format to individuals with disabilities by calling the Career Development Center at 507-389-6061 (V), 800-627-3529 or 711 (MRS/TTY).