SUMMER EMPLOYMENT APPLICATION Upward Bound Program University of Hawaii at Hilo Please place a check mark in the box(es) to the left of the job title you are applying for. Weekday Residential Advisor Weekend Residential Advisor Academic Coordinator Overnight Residential Advisor Instructor / Instructor Assistant Meal Checker Overnight Residential Advisor Team Leader Tutor Please type, or print legibly in blue or black ink. LAST Name FIRST Name MI Mailing Address City State Zip Home Phone Number Alternate Contact Number Social Security Number - - Date of Birth / / Female Male Email Address Are you a US citizen? Yes If you are not a US citizen, please attach documentation to show that you are eligible to work in the US (i.e., permanent resident card, work visa, work permit, etc.) Have you ever been convicted of a felony? Yes Do you have a valid driver s license? Yes Do you have transportation? Yes If no, how will you report to your place of work? Are you available to work nights and weekends? Yes How many hours per week are you available to work? Sunday Monday Tuesday Wednesday Thursday Friday Saturday Start: Start: Start: Start: Start: Start: Start: End: End: End: End: End: End: End: Do you have other time commitments during the summer besides Upward Bound (e.g., another job, taking classes) Yes If yes, list the commitments, days and hours per week. EDUCATION School Name Location Years Attended Diploma, Degree and/or Certificate Completed Year of Completion
CURRENT COLLEGE STUDENTS School Major Career Goal Class Standing: Freshman Sophomore Junior Senior Other Enrollment Status: Full Time 3/4 Part Time Expected date of graduation (sem/yr) Cum. GPA (as of last semester) FORMER COLLEGE STUDENTS Did you graduate? Yes If yes, when (sem/yr)? School Major Average GPA Degree Complete this section if applying for Tutor Position: The following section asks you to rank how comfortable you are in explaining concepts in specific subjects that you may need to tutor high school students. Please rank by circling one of the numbers, where a 4 is a subject that you are very comfortable with and 1 being the least comfortable. Also list below any additional subjects you are very comfortable (3 to 4) in tutoring in the other subject section. Math: Pre-Algebra 1 2 3 4 Science: Marine Science 1 2 3 4 Algebra I 1 2 3 4 Environmental Science 1 2 3 4 Geometry 1 2 3 4 Chemistry 1 2 3 4 Algebra II 1 2 3 4 Physics 1 2 3 4 Trigonometry 1 2 3 4 English: Reading 1 2 3 4 Pre-Calculus 1 2 3 4 Composition 1 2 3 4 Calculus 1 2 3 4 Grammar 1 2 3 4 Literature 1 2 3 4 Other subjects: Complete this section: Check the boxes that you have experience in: Mac PC Excel Word Processing Spreadsheet Power Point Publishing & Graphics Typing Web Design 10-key Data Entry Filing Copy Machine Inventory Fax Machine Customer Service
EMPLOYMENT EXPERIENCE Instructions: Begin with your present employment or last job held and list all full-time and part-time experience. Describe in detail nature of work personally performed by you. Be sure to list each change in title or promotion separately if your duties and responsibilities changed while working for the same employer. May we check with your employment record with your present and former employers? Yes Hours per week: (Salary or Hourly) Start: $ End: $ Reason for Leaving: Hours per week: (Salary or Hourly) Start: $ End: $ Reason for Leaving:
REFERENCES (list three business/professional references that are NOT related to you) Name Job Title/Company Contact Phone Years Acquainted
Personal Statement: Write a brief paragraph detailing how you are qualified for the position you are applying for, and why you would like to work with the Upward Bound Program. Use a separate sheet if necessary. I hereby authorize the University of Hawaii at Hilo Upward Bound Program to maintain and release to prospective employers and appropriate offices the information contained in this registration file. I also release my wage earnings information to Student Employment Office upon request. I certify that all answers given herein are true and complete to the best of my knowledge. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. In order to be considered for review the following required documents must be submitted with the application: A resume, an unofficial transcript, two letters of recommendation and a current school schedule. Signature Date An Equal Employment Opportunity/Affirmative Action Institution