Student Employment Application Apply for a Job General Information First NameLast NameMI Campus address (Residence Hall) Email address (Home or University of Lynchburg) Home Phone (including area code)Cell Phone (including area code) Home Address Street CityStateZip Academic Information Semesters you intend to work Fall Spring Month: Intended MajorMinor (if applicable) G.P.A. (College, or high school for freshmen) Anticipated Graduation Year (College) Did you receive a Federal Work-Study award as part of your Financial Aid Package? Yes No Not Sure Enrollment Status for Academic Year Full Time (12-18 credit hours) Part Time (6-11 credit hours) Number of credit hours enrolled per semester Fall Spring Classification: Freshman Sophomore Junior Senior Graduate Work Experience (On or Off Campus) Please list any employment experience (including campus employment): Company NameSupervisorPositionDuties Company NameSupervisorPositionDuties List any extracurricular activities you are/plan to be involved in on campus (i.e. sports, organization) Skills Computer Skills Please indicate your level of computer skills (1 indicates minimum knowledge and 5 indicates extensive knowledge of computer skills). Word processing (i.e., Word, Google Docs) 1 2 3 4 5 Spreadsheet applications (i.e., Excel, Google Sheets) 1 2 3 4 5 Database (i.e., Access) 1 2 3 4 5 Computer hardware: Windows operating system 1 2 3 4 5 Computer hardware: Mac OSx operating system 1 2 3 4 5 Web page development/design (i.e., Dreamweaver) 1 2 3 4 5 Experience with video editing software 1 2 3 4 5 Other Skills: (e.g., photography, video, tutoring, graphic design, landscaping) I understand that submitting this application does not guarantee employment. I understand that University of Lynchburg will only hire United States citizens and aliens lawfully authorized to work in the United States. All new employees must complete an Employment Eligibility Verification Form (I-9) and present evidence of identity and employment eligibility. If selected for a position, I agree to the terms and conditions for the job assignment. I also understand that I will not be authorized to begin work until I have completed all the necessary paperwork and received approval from Human Resources/Student Employment Office. Yes NoDateInitials If you would like to submit a resume as supplemental information to this application, please send as an attachment to student-jobs@lynchburg.edu. A listing of vacant positions can be found on your Hornet HQ site. Please email the Student Employment Coordinator, student-jobs@lynchburg.edu, to indicate your interest. University of Lynchburg is an equal employment opportunity employer. University of Lynchburg Student Employment Office 1501 Lakeside Drive Lynchburg, Virginia 24501-3113 Telephone 434.544.8142 FAX 434.544.8658