ROCKY'S REC CREW APPLICATION

ROCKY'S REC CREW APPLICATION

Campus Recreation Student Employment
Date

MonthDayYearHourMinutesAM/PM Option
Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
WIU ID#*
Cell Phone Number*

Area CodePhone Number
Year in School*
Major*
What is your current age?
What is your FIRST choice of area to work in Campus Recreation?*
Positions with * require specific certifications or skills.
What is your SECOND choice of area to work in Campus Recreation?*
Positions with * require specific certifications or skills.
Please check the certifications & aptitudes you currently hold.

Standard First AidAdult CPRAEDLifeguarding (Ellis, Red Cross, StarGuard)Certified Personal Trainer/Group Fitness Instructor (ACSM, ACE, NSCA, NASM)Adobe Illustrator, InDesign, Photoshop proficientBASSETT training for selling alcoholOther

I certify that all the information given in this application is true. I understand that any false statement made herein or omission of convictions or current criminal charges is sufficient reason for rejection of this application or termination of subsequent employment. I further authorize the University to investigate all statements made on my application for employment. I authorize such educational institutions and employers and others (and their agents or employees) to respond to questions concerning information given in this application and I further release from liability such former employers, institutions, or persons providing such information to the University.
Please read the following statements and check the appropriate boxes based on your ability to fulfill the statement.

I am currently enrolled for classes at WIU.I am available and willing to work during school break periods and holidays.I am available and willing to work during the summer.I am available and willing to work weekends.I am enrolled for 6 or more semesters hours for the current semester.
Western Illinois University complies fully with all applicable federal and state nondiscrimination laws, orders, and regulations. The University is committed to providing equal opportunity and an educational and work environment for its students, faculty, and staff that is free from discrimination based on race, color, religion, sex, national origin, sexual orientation, ethnicity, age, marital status, disability, or veteran status.

Campus Recreation
Western Illinois University
1 University Circle
Macomb, IL 61455
Phone: (309) 298-1228
wiu.edu/campusrec
Signature of applicant (not required)

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