Student Intern Employment Application Form by D6K9rJ4B

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									                   School of Leadership Studies
                   Student Staff Employment Application Form
                   Questions? Call 785-532-6085

                   Please complete the following information and return:
                   103 Leadership Studies Building
                   Attn: Tamara Bauer or Lori Kniffin

                   Please attach resume and current class schedule with your application.


                               School of Leadership Studies Student Staff Qualifications

                              Current K-State student
                              Taking courses, enrolled in the minor, or involved in programs through SLS
                              A GPA minimum of 2.5
                              Strong communication skills (both verbal & written)
                              Initiative /go-getter mentality
                              Flexibility for new projects or situations
                              Readiness to answer the “unasked question”
                              Energetic team player



Name___________________________________________________________ Date_______/_______/_____________

Local Address____________________________________________________ City_____________________________

State__________ Zip code______________ Phone #_____________________ E-mail address_____________________

Major________________________ Minor(s)___________________________ GPA ____________________________

Year:    FR      SO       JR       SR       5+        Anticipated Graduation Date______________________________

I am enrolled in the Leadership Studies Minor                 Yes_________       No________

I have been involved in programs through Leadership Studies      Yes_________       No________
         Please list all that apply:

Physical Requirements: Due to variety of responsibilities, you must be able to move/carry objects of 30 lb. weight. Can you do this?
YES_______ NO_________

How many hours are you looking to work per week? ____

Are you willing to work evenings (5pm-9pm)?          YES_____ NO____

Would you be available to work during the summer? YES_____ NO____

Have you been awarded Federal Work Study (FWS)? Yes ______ No ______ Amount__________________

List the College, Business or Vocational Schools you have attended.
Name and Locations of Schools                        Dates Attended             Degree(s)




Please list experience and computer skills in software applications:-
__________________________________________________________________________________________________

__________________________________________________________________________________________________
References
List two references that can provide information about your related experiences. If you are currently a K-State student, you MUST
list a K-State faculty or staff member as one reference. If you are a new or transfer student, one reference MUST be from a faculty
member from your respective high school, community college, or other university. For your second reference, please do not use
relatives or close personal friends.

Faculty Reference
Name: _______________________________________________ Job Title: _____________________________

School:______________________________________________ Department:____________________________

Address: _____________________________________________                                    Phone ____________________________

How long you have known this person: ___________________________________________________________

Employer Reference

Name: _______________________________________________ Job Title:______________________________

Company:____________________________________________ Start Date: __________ End Date:_________

Address:______________________________________________ Phone:________________________________

Hours per week: _____________ Reason for leaving_________________________________________________

Responsibilities: _____________________________________________________________________________

Skills Attained:______________________________________________________________________________


Short Answer
In 500 words or less, please explain why you would like to be on Student Staff at the School of Leadership Studies.
_______ ___________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


To the best of my knowledge, all answers to the foregoing are true and correct. I hereby grant permission to Kansas State
University to contact each of my former employers listed above concerning my qualifications for employment. Permission is
also granted to each of my former employers to give Kansas State University information they may have with respect to my
work experience with them.
                                                  Signature________________________________
Notice of Nondiscrimination:
Kansas State University is committed to nondiscrimination on the basis of race, color, ethnic or national origin, sex, sexual orientation, gender identity, religion, age,
ancestry, disability, military status, veteran status, or other non-merit reasons, in admissions, educational programs or activities and employment, including employment
of disabled veterans and veterans of the Vietnam Era, as required by applicable laws and regulations. Responsibility for coordination of compliance efforts and receipt
of inquiries concerning Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and the Americans With Disabilities Act of 1990, has been delegated to the Director of Affirmative Action, Kansas State University, 214
Anderson Hall, Manhattan, KS 66506-0124, (Phone) 785-532-6220; (TTY) 785-532-4807.
Revised April 22, 2008.

								
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