Personal Data

First name:

         MI

Last name:

Email address:

Local/Cell Phone

Local address/City/State:

Major/Minor:

Banner ID:

Educational Data

(If presently pursuing a degree, list degree and date anticipated)

Name of school/Major:

Date Received/GPA:

Name of school/Major:

Date Received/GPA:

High School:

Date Received/GPA:

Employment Data

(Most recent first; Please note part-time (P) or full-time (F)

Employment #1

Position:

Part-time/Full-Time:

Supervisor:

Dates of Employment

Employment #2

Position:

Part-time/Full-Time:

Supervisor:

Dates of Employment

Reference

First name:

Last name:

Relationship to you:

Phone

Miscellaneous

Check areas in which you would be comfortable assisting students:

Check all that apply

Composition:

 Brainstorming Ideas

 Outlining/Organizing

 Grammar/Mechanics

Math:

Algebra 1

Geometry

Algebra 2

Trig

Calculus

Hobbies/Interests/Organizations that relate to this position

Would you be able to transport under-age students in University vans?  Yes No

{Please do not answer “yes” unless you have a valid driver’s license, a safe driving record, and are willing (with training) to operate a 14-passenger van with under-age passengers.}

Have you ever been released from employment?  Yes No   

(If yes, please provide an explanation which includes the employer’s name, address, and phone number.)

Written Responses

(Please provide brief, but thorough responses)

Why have you applied for this position?

Please describe specific qualifications, experiences or skills that would enable you to effectively work and interact with students and parents served by the Scholastic Enhancement Experience Program. Briefly highlight your experiences supervising and/or mentoring high school or college students.

   SEE Counselors are responsible for developing and facilitating one weekend’s worth of activities for SEE participants during the course of the program. These programs usually focus on topics that will aid participants on becoming a successful, engaged and active student. With this in mind, what ideas/programs do you think would be most beneficial to an incoming Truman student? What resources would you utilize for this presentation?

Confidentiality Agreement

You are applying for a residential position, please initial that you are aware that you must live in the residence hall for the duration of the Scholastic Enhancement Experience Program. (initials)

I realize that to assure consideration of my application, I must do the following no later February 29, 2008 at 5 PM:

1)     submit my college transcript (unofficial or official)

2)      arrange for two (2) recommendations to reach Laura Bates by the deadline

3)      submit a brief résumé

I understand that the falsification or omission of information can lead to refusal to hire or to discharge.  I hereby give SEE my consent to check references.  I understand that employment is subject to a background check and may be subject to passing a drug test.  I agree that I will not hold Scholastic Enhancement Experience personally responsible for any result of the reference checks.  If employed, I give Scholastic Enhancement Experience permission to publish pictures, press releases, video footage, or use other media to highlight my involvement and program accomplishments.

Signature:

Date: