Job Type:

. Front Office Assistant Tutor Night Monitor Peer Mentor Personal Assistant to Program Coordinator Webmaster Tutor Coordinator Other

If applying for more than 1 position, please type in the box below the additional positions.

Additional Positions:

I qualify for:

Check all that apply

  Scholarship work Work-study Institutional

Personal Information

First name:

Last name:

Email:

Local Phone

Address:

100 E. Normal Street, Apt 1, Kirksville, MO

Major/Minor:

Cumulative G.P.A:

Credits after current semester:

Banner ID:

Employment Survey

I can begin working:

Immediately Next Month Next Semester Next Year Other

Can you work weekends?

No Saturday Only Sunday Only Saturday and Sunday

I have experience with:

Please select all that apply.

  Word Power Point Excel (Spreadsheet)Publisher

  Front Page (Web design) Access (Database)Other (Please specify below)

Other computer experience:

Have you worked on campus before?       Yes      No

If yes, please complete the following information.

Supervisor:

Department or Division

Multicultural Experiences & Activities

Please list multicultural activities you have been a part of or multicultural experiences you have had.

Off Campus Employment Data

Employment #1

Supervisor:

Phone number:

Dates of Employment

Employment address:

100 E. Normal Street, Apt 1, Kirksville, MO

Please list duties performed during your employment.

Tutor Supplement only

I prefer to tutor these subjects/courses:

Subject

Class

Professor Reference

Name:

Course:

Peer Mentor Supplement only

In 100 words or less, please answer the following questions below:

• Briefly discuss the qualities you feel are most critical in a Mentor/Mentee relationship

• What ideas/programs do you think would be most beneficial to an incoming Truman student?

• Identify 2 campus resources you feel a first year student needs to be aware of and briefly explain why.

Confidentiality Agreement

By submitting this application, I give MAC staff the permission to perform a reference and grade check. I understand that the falsification or omission of information can lead to refusal to hire or to discharge. I agree that I will not hold the MAC personally responsible for any result of the reference checks.

As a student assistant at Truman State University, I understand that a great deal of highly confidential student and employee information is processed in the course of everyday work. This confidential information may include such things as written materials, electronic communications and conversations about personal matters.

In cooperation with the Federal Family Educational Rights and Privacy Act of 1974 (The Buckley Amendment) I understand that confidential information is never to be taken from the office or discussed with anyone outside the office. I agree to maintain this privacy policy at all times. Further, I understand that any breach of this agreement may result in my immediate dismissal and the possibility of additional disciplinary action.

Signature:

Date: