Campus Recreation
One UTSA Circle
San Antonio, TX 78249
Phone: 210-458-7575 Fax: 210-458-7272
www.utsa.edu/recreation
Application for Employment
Outdoor Pursuits Student Assistant
Personal Information
Last Name: First Name: Banner I.D.:
Address: City: Zip:
Phone #:
Email:
General Information
University classification: ☐Freshman ☐ Soph. ☐ Jr. ☐ Sr. ☐ Grad Graduation Date:
Are you presently employed by Campus Rec.? ☐ No ☐ Yes Program Area:
Are you presently employed on campus? ☐ No ☐ Yes Where?
Have you previously been employed by UTSA? ☐ No ☐ Yes Where & When?
Are you certified in Adult and Child CPR with AED? ☐ No ☐ Yes Expiration Date:
Are you certified in First Aid? ☐ No ☐ Yes Expiration Date:
Are you willing to work evenings, weekends, and holidays? ☐ No ☐ Yes
Position(s) In Which You Are Interested
☐ Outdoor Resource Center ☐ Rockwall ☐ Trip Leader
FALL 2014 Availability
To help us consider you for a position that matches your availability, please check only shifts you are available to work.
Weekday Shifts:
Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday8:45 a.m. – 10:45 a.m. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
10:45 a.m. – 1:00 p.m. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
11:45 a.m. – 2:00 p.m. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
12:45 p.m. – 4:00 p.m. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
3:45 p.m. – 7:00 p.m. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
4:45 p.m. – 8:00 p.m. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
6:45 p.m. – 10:00 p.m. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Skills/Qualifications
Qualifications/Certifications:
Outdoor Trips Experience (personal or professional):
Q1. Please tell us why you would like to work for the Outdoor Pursuits program within the Department of Campus Recreation.
Q2. Please share any outdoor recreation experience and/or skills you possess, which would assist you being successful in this position.
Q3. Please share how you could contribute to our ability to provide quality customer service to outdoor pursuit’s participants.
Q4. Please explain how you would promote diversity and inclusion as staff member within Campus Recreation.
Q5. What do you feel are some of your strengths as it relates to the work environment? What are some areas you see a need to improve on?
Work History
Job Title Supervisor Employment Dates
Company Phone Number Company Name & Address Reason for Leaving
Job Title Supervisor Employment Dates
Company Phone Number Company Name & Address Reason for Leaving
References
Reference Relationship Phone Number
Reference Relationship Phone Number
To the extent provided by applicable law, no person shall be excluded from participation in, denied the benefits of, or be subject to discrimination under, any program or activity sponsored or conducted by the University of Texas System or any of its component institutions, on the basis of race, color, national origin, religion, sex, age, veteran status, or disability.
It is the policy of UTSA to strive to maintain an educational and work environment free from impermissible discrimination. In addition to compliance with all applicable federal and state laws and regulations, no person should be subjected to discrimination on the basis of sexual orientation regarding admissions, employment, or access to programs, facilities or services of UTSA. (UTSA Handbook of Operating Procedures, Chapter 9, Section 9.1 Statement on Nondiscrimination)
I believe and understand that the information I’ve provided is true and that any false or misleading information is sufficient grounds for disqualification of this application or termination of employment.
Signature: Date: