Date:
Signature:
Workstudy Application
Human Resource Office
1704 Market Street, Room 125
Wheeling, WV 26003
(304) 214-8901
West Virginia Northern Community College is an Affirmative Action/Equal Opportunity Organization
that does not discriminate against any individual on the basis of race, religion, national origin, creed,
sexual orientation, age, or disability.
First Name:
PERSONAL INFORMATION
Middle Name:
Last Name:
Mr.
Mrs.
Ms.
Student ID #:
Telephone #:
Street Address:
Mailing Address:
(If different than Street)
City: State: Zip:
E-mail:
Date available for workstudy employment:
County:
EDUCATION
Indicate highest school grade completed:
2 31
11
10987654
12
Earned Equivalent GED?
No
Yes
EMPLOYMENT HISTORY
(Most current to oldest)
Expected Graduation Date:
Current hours registered:
Current GPA:
Company:
Your title:
Dates of employment:
Business type:
Dates of employment:
Your title:
Business type:
Company:
Dates of employment:
Your title:
Business type:
Company:
Current Major:
SKILLS AND QUALIFICATIONS
(Summarize any training or skills that may qualify you as being able to perform job-related functions in this position)
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signature
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