If you would prefer to print your application to hand deliver or mail, click to download in pdf format.

 

   
   
    
Year:   Major:

 

 

Contact Information:

  Home:   School:
  Address:     Address:  
  City:     City:  
  State:     State:  
  Zip Code:     Zip Code:  
       
  Phone:     Phone:                    

 

 

Availability:

Are You Available During the Summer? Yes No
Are You Available During Breaks? Yes No
Are You Available Saturdays? Yes No
Are You Available To Start Working Immediately? Yes *No
  *If No, when are you able to start working:

 

 

Experience:

 

Most Recent Employer:
Address:
Contact:

 

Reason for Leaving:

 

Describe the Type Work Experience You Have Had:
 

Why would you like to work at the Co-op Store?

 

 

References:

 

  Name:     Name:  
  Address:     Address:  
  City:     City:  
  State:     State:  
  Zip Code:     Zip Code:  
       
  Phone:     Phone:  

 

 

Are you eligible to work in the U.S.?  Yes No
If you are under the age of 18, do you have an employment/age certificate?  Yes No
Have you ever been convicted of a criminal offense (felony or misdemeanor)? *Yes No
  *If Yes, please describe:
(Conviction will not necessarily disqualify an applicant for employment)
 

 

 

Please type class schedule from 8:00 a.m. - 6:00 p.m.

(example: Monday 8:00 a.m. - 8:45 a.m. ENGL 311)

 

  

 

(Please click submit only once. It may take a few minutes to process your information)

 

 

 

Thank you for considering working at your student owned Co-op Store!