Last Name First Name Middle Name
Current Address
Phone Number
Cell Phone
Email
(Please Indicate Preferred Number where you can be reached to set up an interview date and time.)
Date of Birth:
Sex: Male Female
Currently Enrolled at CSULB: Yes No
If so, What is your class status: Freshman Sophmore Junior Senior Graduate
Student ID
How did you hear about this position? (Required)
Booth Stakes/ Fliers 49er AD SOAR Other Source
High School GPA
Major
Career Goal
Anticipated Year of Graduation
Clubs/ Activities
Relation
Permanent/Emergency Address Permanent/ Emergency Address
I. Name and Location of Employer:
Your Title and Duties
Date Employed From to
Reason for Leaving
II. Name and Location of Employer:
Name
Phone
Have you ever worked on campus before?
Date Employed From To
Briefly describe a situation or experience where your communication skills aided you in being persistent and persuasive:
Do you fluently speak a language other than English? Yes No
If yes, what language
Monday 6:00 - 9:00 pm Tuesday 6:00 - 9:00 pm Wednesday 6:00 - 9:00 pm Thursday 6:00 - 9:00 pm Friday 3:00 - 6:00 pm Saturday 10:00 am - 01:00 pm Saturday 02:00 pm - 05:00 pm Sunday 10:00 pm - 01:00 pm Sunday 01:30 pm - 04:30 pm Sunday 05:00 pm - 08:00 pm
Are you available to work during the winter? Yes No
Are you available to work during the summer? Yes No
Do you have night classes: Yes No
The information I have given on this application is true to the best of my knowledge. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an employment offer, or if I am hired, my dismissal from employment.
Fill out the online application on the left or print out the application form and return it to:
