Physics/Geosciences Department

STOREROOM Assistant Semester Applying For: ________________ Year: ________

APPLICANT INFORMATION

Last Name First M.I. Date

Street Address Apartment/Unit #

City State ZIP Cell Phone Home Phone

TAMUK E-mail Address

Personal E-mail Address

Previously Applied? YES NO M F

Social Security No. YES NO

Social Security No. Student ID K _ _ _ _ _ _ _ _

Are you now employed by TAMUK?YES NO

Are you a citizen of the United States? YES NO

If no, are you authorized to work in the U.S.? YES NO

Have you ever worked for this university? YES NO

If yes, when/where?

EDUCATION Previous College

City

From To Graduated? YES NO

GPA GPA (Presently)

Expected Degree Date

Major Minor Clubs/Organizations

EXPERIENCE (CHECK ALL THAT APPLY)

Excel/Spreadsheets Filing Fax Machine Mail Distribution

Typing/Keyboarding Binding Manuals Copier Multi-line telephone

MS Office Suite Publications/Flyers Receipting Public Relations

CURRENT SCHEDULE (SHOW ALL COURSES, MEETINGS, OR OTHER ACTIVITIES TO CONSIDER WHEN DETERMINING YOUR SCHEDULE)

Monday Tuesday Wednesday Thursday Friday 8:00 30

9:00 30

10:00 30

11:00 30

12:00 30

1:00 30

2:00 30

3:00 30

4:00 30

5:00 30

DISCLAIMER AND SIGNATUREI 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 immediate termination.

Signature: Date: