Work Study Application

Work Study Application
Applicant Information
Name*

First NameLast Name
Student ID*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
What positon are you applying for?*
Which semester are you intrested in applying for?*
Have you ever been convicted, released, or plead no contest to any felony offense?*
A conviction record will not necessarily disqualify you for employment. Each case is considered on its own merits. If yes, indicate the nature, date, court and disposition.*
Have you ever been employed at Heritage University?*
If yes, when were you employed at Heritage University?*
May we contact your former supervisor?*
Education
Are you currently enrolled at Heritage University?*
If you are currently enrolled, what is your major?*
I am currently a:*
I am enrolled:*
Availability

Please provide the hours you are currently available for each day listed below

Type a question*

Extracurricular Activities
List any extracurricular activities or club/officer affiliation:
Previous Employment
Last/Current Employer
Supervisor Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Employment
Last Day of Employment
May we contact this employer?
Please list your job duties below:
Reason for leaving:
Additional Information

In which of the following areas do you have previous experience? Check all that apply.
WordExcelEmailPowerPointPublisher
PhoneConfidentialityFilingInventoryReception Area
CookingServingMeasuringCleaningFood Handler's Card
BookkeepingAccountingCashier10-KeyBanking
Greeting CustomersHandling InquiriesMulti-taskingInventoryAnswering Phones
Language abilities, other than English:
Speak
Read
Write
Please list any other skills you have below:
Disclaimer and Signature
I certify the information contained in this application is true, correct, and complete. I understand that, if employed, false statements reported on this application may be considered sufficient cause for dismissal. If hired through the work study program I understand that I must maintain academic satisfactory progress. Completing this application does not guarantee work study placement or funding.*

Clear
Date

MonthDayYear
Date
Have Questions About Your Workstudy Eligibility?

Please contact the Office of Financial Aid at (509) 865-8502 or financial_aid@heritage.edu
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Applicant Information