NAME:   LAST FIRST MIDDLE
Local Phone (including area code): Local Address: STREET CITY STATE ZIP Permanent Address: (if different from above) STREET CITY STATE ZIP Phone (including area code): Email Address :
POSITION FOR WHICH YOU ARE APPLYING:
Present or most recent employer: Name of Employer: Location: Phone: (including area code) Supervisor's Name: Supervisor's Email : Dates employed: until Duties performed:   Previous Employer: Name of Employer: Location: Phone: (including area code) Supervisor's Name: Supervisor's Email Dates employed: until Duties performed:
Work References from Former Employers   Reference #1   Reference #2 Name: Name: Email: Email:     Phone: Phone:
Other related work experience/skills:	This application is for: (check one)       Fall   Spring     Summer
What is your major?	Are you Work Study qualified?     YES     NO
Hours per week you wish to work?     hours	Available Midnight to 7am?     YES     NO
Please select one:     ISU Freshman ISU Sophomore     ISU Junior ISU Senior     ISU Graduate Student	Please provide us with your schedule of times you will be AVAILABLE to work.

PLEASE READ AND FILL IN YOUR FULL NAME BELOW   The facts set forth in my application for employment are true and complete.  I understand that if employed, any false statement on this application may result in my dismissal.  I further understand that this application is not and is not intended to be a contract of employment, nor does this application obligate the employer in any way if the employer decides to employ me.  I understand and agree that my employment is at-will and can be terminated by either party with or without notice, at any time, for any reason or for no reason.  No one other than an officer of the Company has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing and then only in a writing signed by an officer. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice.        Name: Date:

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