Fillable Student Employee Application (Clovis Community College)

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Student Employee Application (Clovis Community College)

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04/15/16
APPLICATION FOR
STUDENT EMPLOYMENT
Fall Spring Summer
PLEASE PRINT NEATLY
Yes
No
Are you currently a high school student?
(If yes, you are not required
to file a FAFSA)
Sophomore
Junior
Senior
Have you completed and submitted a Free Application for Federal Student Aid (FAFSA)?
Yes No
Student Employment applications are kept on file for ONE SEMESTER ONLY
****** You must complete a new application for employment each semester you are seeking employment. ******
Type of Work Preferred
Auto
Health & Fitness
Other:___________________________
Office Work
Maintenance
Have you previously worked for Clovis Community College?
Yes No
If yes, please list which area(s) and supervisor(s).
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Please list names of any of your relatives currently employed at Clovis Community College.
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Skills (For example: computer programs, customer service skills, maintenance, repairs, etc….)
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
School Experience
1
st
Year 2
nd
Year 3
rd
Year Major: ____________________________ Expected Graduation Date: _____________
Current GPA: _____ List classes taken which might relate to this job:
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Campus Hours of Operation
Monday – Friday
Monday – Thursday: 8 a.m. –5:00 p.m.
Friday: 8 a.m. – 4:30 p.m.
Health & Fitness Center
Monday – Friday: 6 a.m. – 8:00
p.m.
Additional offices: 8 a.m. – 8:00 p.m. Saturday: 8 a.m. – 2 p.m.
Center for Student Success
Monday – Thursday: 8 a.m. –8
p.m. Friday: 8 a.m. – 4:30 p.m.
FOR HRS OFFICE USE ONLY
Enrolled Last Semester _____
Enrolled This Semester _____
# Of Credit Hours _____
Background Check _____
Financial Aid _____
Additional References Required ____
Name: _________________________________________________________________________________________
Last
First
Middle
Address (Street, City, State, Zip): ____________________________________________________________________
Telephone Number: ___________________ Email Address:______________________ Banner ID: _____________
dsaf
If you are in high school, please specify your grade level.
American Reads
Library
Security
Reset Form
04/15/16
APPLICATION FOR STUDENT EMPLOYMENT Page 2
Are you available to work weekends and evenings? Yes No
If yes, please list times: ______________________________________________________________________________________________
__________________________________________________________________________________________________________________
Schedule (List your class schedule for the semester for which you are applying.)
CLASS DAYS TIME
Work Experience
References (Indicate 3 non-related references and include name, phone number and relationship)
1. _____________________________________________________________________________________________________
2. _____________________________________________________________________________________________________
3. _____________________________________________________________________________________________________
Employer: _______________________________________________________ Dates Employed: __________________________
Location: ________________________________________________________ Reason Left: _____________________________
Duties Performed: _________________________________________________________________________________________________
________________________________________________________________________________________________________________
Employer: _______________________________________________________ Dates Employed: __________________________
Location: ________________________________________________________ Reason Left: _____________________________
Duties Performed: _________________________________________________________________________________________________
________________________________________________________________________________________________________________
Employer: _______________________________________________________ Dates Employed: __________________________
Location: ________________________________________________________ Reason Left: _____________________________
Duties Performed: _________________________________________________________________________________________________
________________________________________________________________________________________________________________
04/15/16
APPLICATION FOR STUDENT EMPLOYMENT Page 3
Please read and initial the following:
______ I understand that unless I am a current high school student, I must complete a FAFSA.
______ I understand that Clovis Community College policy requires that all student employees must be enrolled in six credit
hours during the spring and fall semesters and three credit hours in the summer semester.
______ I understand by accepting employment at Clovis Community College, the college reserves the right to terminate me at
any time with or without cause.
______ I understand I may be terminated if I knowingly make false statements or omissions on this application for
employment.
______ I understand that a reference/background check will be performed before I will be allowed to work on campus.
______ I understand I cannot perform other types of CCC employment while I am a student employee (a part-time instructor,
tutor, mentor or other special services).
______ I understand student employees are exempt from social security taxation (FICA and MQFE). I am aware of the possible
reduction in my future social security benefit entitlement.
Signature: ______________________________________________________ Date: __________________________________
Clovis Community College is committed to equitable treatment of all employees and applicants for employment without
regard to race, age, religion, color, national origin, ancestry, sex, sexual orientation, spousal affiliation, gender identity,
veteran’s status, physical or mental disability or serious medical condition. The college will endeavor to maintain the
confidentially of the information contained in this application to the extent permitted by law.
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Student Employee Application (Clovis Community College)

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Completed 24 July 2020

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