GRCC ON-CAMPUS STUDENT EMPLOYMENT APPLICATION
PERSONAL HISTORY
Name: _________________________________________________ Student ID: __________________ Date: ________________________
Address: ______________________________________________ City: __________________________ State: ______ Zip: ____________
Email: _______________________________________________________________ Phone: _____________________________________
Have you previously worked at GRCC? ___ Yes ___ No *If yes, where and when? ______________________________________________
Are any of your family members employed at GRCC? ___ Yes ___ No *If yes, who and their relation? ______________________________
EDUCATION – COLLEGE, CERTIFICATIONS, HIGH SCHOOL IF RECENT GRADUATE
EMPLOYMENT AND EXPERIENCE
In the space below, list relevant skills that would apply to on campus employment such as computer skills, special training, etc.
___ I AUTHORIZE THE FINANCIAL AID OFFICE TO EVALUATE MY ELIGIBILITY FOR THE FEDERAL WORK-STUDY PROGRAM EACH
ACADEMIC YEAR. I UNDERSTAND THAT I MUST COMPLETE THE FREE APPLICATION FOR FEDERAL STUDENT AID (FAFSA)
ANNUALLY FOR CONSIDERATION.
CRIMINAL BACKGROUND RELEASE CONSENT & SIGNATURE
1. Have you ever been convicted of a crime(s)? This would include both felony and misdemeanor convictions. ___ Yes ___ No
(Having convictions will not necessarily preclude (prevent) you from obtaining employment.) * If yes, please explain when and the nature
of the offense(s): _________________________________________________________________________________________________
________________________________________________________________________________________________________________
2. Do you have any pending criminal charges against you? ___ Yes ___ No * If yes, please explain: _________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
I, ____________________________________, hereby authorize the release of any information to Grand Rapids Community College Police
Department regarding my employment history, arrest or criminal history or any other information pertinent to my potential employment at
Grand Rapids Community College. I certify that all of the statements I have made in the Application for Employment are truthful. If any
statement is found to be false, I agree that is sufficient for my not being hired and if employed, terminating my employment. I understand that
acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.
