Student Worker Application

Applicant Information
*
First Name Last Name Student ID #
*
Major Minor Cumulative GPA
Phone Number*
BSU Email Address*
Permanent Email Address (If different than above)
Local Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Permanent Address (if different than above)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please check your anticipated graduation year:*
- Class of 2022
- Class of 2023
- Class of 2024
- Class of 2025
Are you eligible for work study?*
- Yes
- No
Preference given to students who are work study eligible.
How many hours would you like to work per week?*

During academic year, maximum hours cannot exceed 20 per week. During breaks, maximum hours cannot exceed 40 per week.

References
Please provide three professional references, friends or relatives are not allowed.
*
First Name Last Name Title
*
Relationship Phone Number
*
First Name Last Name Title
*
Relationship Phone Number
*
First Name Last Name Title
*
Relationship Phone Number

Work Experience
Please list previous work experience beginning with your most recent job held.
1. Company Information*
Company Name Your Job Title Supervisor's Name Phone Number
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Dates Employed*
From: To:
List the duties you performed:*
What was your reason for leaving?*
May we contact this employer?*
- Yes
- No
2. Company Information
Company Name Your Job Title Supervisor's Name Phone Number
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Dates Employed
From: To:
List the duties you performed:
What was your reason for leaving?
May we contact this employer?
- Yes
- No

Please describe your computer skills. Give examples.*
Please describe your customer service skills. Give examples.*
Please list any other extra-curricular activities you are involved in, i.e. sports or clubs, and what those time commitments entail.*
Attach your class schedule:*
Max. file size: 977 MB.
Work schedules are based on your class schedule. Please attach your class schedule from E-Services above. As a student worker in this area, you are expected to be available to work fall, winter and spring break.

Bemidji State University