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SIS18-19general Application SIS 14-15 general application

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SCHOLARS IN SERVICE
2018-19 PROGRAM APPLICATION
California State University, Fresno
Instructions:
1. Before completing this application, be sure you are available for a 1-unit
course, details
about which to be given upon hiring.
2. Type or print clearly in blue or black ink. Incomplete applications will not be
considered.
3. Return the completed application package to:
The Jan & Bud Richter Center
Attn: Scholars in Service Program
Thomas Building, Room 107
Applications accepted until all positions are filled.
Questions/More Information: chrisf@csufresno.edu | 559.278.7079
www.fresnostate.edu/academics/cesl/programs/scholars
A complete application package will contain:
This cover sheet
Application
Resume (optional)
Name________________________________________________________________________
Position(s) Applying for (write complete position title as stated on job description):
1)___________________________________________________________________________
2)___________________________________________________________________________
3)___________________________________________________________________________
Interview Availability: Indicate below, the times you are typically AVAILABLE for an interview
during the week.
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
8AM – 9AM
8:30AM – 9:30AM
8AM – 9AM
8:30AM – 9:30AM
8AM – 9AM
9AM – 10AM
9:30AM – 10:30AM
9AM – 10AM
9:30AM – 10:30AM
9AM – 10AM
10AM – 11AM
10:30AM – 11:30AM
10AM – 11AM
10:30AM – 11:30AM
10AM – 11AM
11AM – 12PM
11:30AM – 12:30PM
11AM – 12PM
11:30AM – 12:30PM
11AM – 12PM
12PM – 1PM
12:30PM – 1:30PM
12PM – 1PM
12:30PM – 1:30PM
12PM – 1PM
1PM – 2PM
1:30PM – 2:30PM
1PM – 2PM
1:30PM – 2:30PM
1PM – 2PM
2PM – 3PM
2:30PM – 3:30PM
2PM – 3PM
2:30PM – 3:30PM
2PM – 3PM
3PM – 4PM
3:30PM – 4:30PM
3PM – 4PM
3:30PM – 4:30PM
3PM – 4PM
Scholars in Service Application
AY 2018 – 19
Date
First Name
Middle Name
Student ID #
Are you at least 18 years of age?
Yes No
Cell Phone
Home Phone
Mailing Address
City
State
Zip Code
Primary Email
Secondary Email
Best Way to Contact You:
Cell Phone Home Phone Primary Email Secondary Email
Have you ever been convicted of a criminal offense other than a minor traffic violation? Yes No
If “Yes”, please attach a sheet specifying the nature of the violation, the name and address of the court, and the disposition of the charge.
Language(s) spoken, other than English:
Class Level (beginning Fall 2018) Freshman Sophomore Junior Senior Postgraduate
GPA:
Units Enrolled:
Major(s), Minor(s), Certificate(s)
Are you a returning Scholar in Service?
Yes No
If yes, at which site(s) did you previously serve?
Previous Work/Volunteer Experience, beginning with the most recent. Please attach an additional sheet if necessary.
Employer
Supervisor
Position
Period Employed (MM/YY)
Phone
Mailing Address
City
State
Zip Code
Duties
Reason for Leaving
Employer
Supervisor
Position
Period Employed (MM/YY)
Phone
Mailing Address
City
State
Zip Code
Duties
Reason for Leaving
Employer
Supervisor
Position
Period Employed (MM/YY)
Phone
Mailing Address
City
State
Zip Code
Duties
Reason for Leaving
Do you have transportation? Yes No
How did you hear about Scholars in Service? Please mark all that apply.
Former Scholar In Service Student Email from the Richter Center or Career Services
Information Fair (Dog Days, Community Service Opportunities, Summer Bridge) Posting at Financial Aid Office
Other _____________________________________________________________
You may attach an extra sheet of paper to answer the following questions, if necessary.
A. List your qualifications for a Scholar in Service position (ex. experiences, relevant strengths, special skills, etc.):
B. List your volunteer and/or service-learning experience, beginning with the most recent (include length of commitment,
agency, and a short description of your duties). Then, briefly highlight the most meaningful experience and explain what made it
important to you.
C. Why are you interested in becoming a Scholar in Service? What do you think will be the most rewarding aspects of this
program? What do you hope to contribute to your site?
I certify that the information supplied in this application is correct.
______________________________________________________________________________ ____________
Signature of Applicant Date
Office Use Only
Meets Fin. Aid Req?
Yes No
GPA:
Applicant Status:
New Returning
Group Interview:
Forward Application?
Yes No
Application sent to:
Date Sent
Response
Accepted Deferred
Selection (date & location)
Comments
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SIS18-19general Application SIS 14-15 general application

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Completed 3 November 2019

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