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					Office Use Only Application for Employment Lab Monitor, AV Support, Classroom Support Phone: (702) 895-0762 App. Received by: Interview Date: Interviewed by: Offer Date: Start Date: Pay rate:

Personal Information: Name (First, Middle, Last): Local Mailing Address: City: State: Phone Number: E-mail Address (1): Zip Code: ***Today’s Date: Name and Address Position Applying For (Put down all that apply): Permanent Mailing Address: City: State: Phone Number: E-mail Address (2): Zip Code:

Position Information: Semester applying for: Credits Enrolled for: General Year applying for:
You must be enrolled in six (6) or more credits.

Major: Class (Fresh, Soph, Junior, Senior, Grad):

Education Expected Graduation:

Employment Have you been given a Work Study Award: Yes No If you have another on-campus job, how many How many hours would you like to work in this hours are you working:* position: If Referred by whom: Which Lab or Academic Discipline would you like to work for (preferred Labs)

Sci / Engr CBC-B131 and TBEA311 Labs

Bus/Hotel BEH Labs

Fine Arts Arc/Art/Music/ Media Labs

Lib Arts / Urban FDH/MSU Labs

Education and Health Sciences CEB/BHS Labs

No Preference

*Students may not work more than forty (40) hours per week
or 8 hours per day (combined) if they work more than one job on campus

Based on your planned class schedule, please put an X for the days and times you can work:
If you can't work an entire hour of time, please indicate the times you can work in the box (see example column) Shift Example Mon Tue Wed Thu Fri Sat Sun 7am – 8am X 8am – 9am X 9am – 10am 9-9:20 10am – 11am 11:30-12 11am – 12pm 12pm – 1pm X 1pm – 2pm X 2pm – 3pm X 3pm – 4pm X 4pm – 5pm X 5pm – 6pm 6pm – 7pm 7pm – 8pm 8pm – 9pm 9pm – 10pm 10pm – 11pm 11pm – 12pm 12pm – 1am

Previous Employment History Please list in order of most recent: Employer: Dates of Employment: Position Title: Phone Number: Employer: Phone Number: Reason For Leaving: Dates of Employment: Reason For Leaving: Personal References Address: Phone Number: Address: Phone Number: Position Title:



Name: Relationship: Name: Relationship:

Computer Hardware and Software Knowledge/Experience Please describe your knowledge of the hardware/software listed below: Personal Computers: Macintosh: Windows 95/98/NT/XP:

Microsoft Word: Microsoft Excel: Microsoft PowerPoint: Microsoft Access: Adobe Photoshop : Microsoft Publisher: Microsoft FrontPage: Internet (Internet Explorer, Netscape, FTP, etc.): Pioneer/Rebelmail:


Macromedia Products (Flash, Dreamweaver, Fireworks:

Other Adobe Products:


Briefly, can you explain as best you can why you would like to work for our department:

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