Fillable Federal Work-Study Job Application (Louisiana Delta Community College)

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Federal Work-Study Job Application (Louisiana Delta Community College)

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The Federal Work-Study Job Application (Louisiana Delta Community College) form is 3 pages long and contains:

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  • 12 check-boxes
  • 59 other fields

Country of origin: US
File type: PDF

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OFFICE OF FINANCIAL AID
Federal Work-Study Job Application
Semester(s): _____Fall _____Spring _____Summer Year: 20_____-20_____
Applicant Information
Full Name:
Date:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
State
Phone:
( ) ____________________________
E-mail Address:
_____________________________________
Date Available:
___________
Student ID:
_________________________
DOB:
________________
Campus Attendin
g: __________________
Are you authorized to work in the U.S.?
Yes
No
Have you ever worked for this company?
Yes
No
If yes, when?
Have you ever been convicted of a felony?
Yes
No
If yes,
explain:
Education
High School:
Address:
From:
To:
Did you graduate?
Yes
No
College:
Address:
Major:
Graduation Date:
References
Please list two professional references.
Full Name:
Relationship:
Company:
Phone:
( )
Address:
Email
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L A D E L T A . E D U M O N R O E , L A 7 1 2 0 3
Signature Disclaimer and Authorizations Disclaimer and Authorizations
OFFICE OF FINANCIAL AID
Full Name:
Relationship:
Company:
Phone:
( )
Address:
Email
Company:
Phone:
( )
Address:
Supervisor:
Job Title:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
Yes
No
Previous Employment
Company
:
Phone
:
( )
Address
:
Supervisor:
Job Title:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
Yes
No
Skills and Qualifications
Please list your skills here: (for example, Create Word Documents using Microsoft Word)
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OFFICE OF FINANCIAL AID
Disclaimer and Authorizations
I authorize LDCC Financial Aid to use information on this application to facilitate my assignment to a FWS Student Employment job.
I understand that FWS earnings are (1) contingent upon receiving a job offer, (2) hours worked, (3) subject to taxation, (4) and that I
must be enrolled at least 6 hrs.
I understand that, prior to beginning work on the FWS program; I must complete and submit (1) proof of my identity and eligibility to
work in the US and (2) a Federal W-4 form.
I understand that my performance will be evaluated and that I can be terminated for attendance issues or unacceptable job
performance.
I understand that confidentiality is of the utmost importance in any job placement.
I understand that this job application will be active until the end of the current academic year and that I may withdraw the application
by contacting LDCC Office of Financial Aid..
I 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 release.
Signature:
____________________________________
Date:
_________________________________
FWS Student Job Seekers: A SIGNED copy of this application must be submitted to the Office of Financial Aid.
RETURN TO:
The Office of Financial Aid
Louisiana Delta Community College
7500 Millhaven Road, Monroe, LA 71203
Phone: (318) 345-9005 www.ladelta.edu
NOTE: When you submit your application for a specific FWS position, you MUST include a copy of this application. You are free to attach your own résumé,
cover letter, and letters of recommendation to this application when submitting it for consideration of a specific job. When you are no longer in an active job
search, please notify us to withdraw this application.
Rev. 09/12/18
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L A D E L T A . E D U M O N R O E , L A 7 1 2 0 3
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Federal Work-Study Job Application (Louisiana Delta Community College)

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Completed 16 September 2020

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