Application for Student Employment

Application for Student Employment
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
crunk@cru.umhb.edu
Date of Birth*

MonthDayYear
Date
Student ID*
Classification (Freshman, Sophomore, Junior, Senior)*
Major*
Do you participate in the UMHB Student Work/Study Program?*

YesNo
EXPERIENCE

Please briefly describe any employment experience here. (You may include work done as a volunteer.)
Employer*
Work Performed*
Dates of Employment (Month/Year - Month/Year)*
**If you have any additional work experience, please add details here.
Please list all subjects (course names) you would be willing to tutor.*
You must have received a "B" or higher (preferably an "A") in the course(s) you tutor.
ACADEMIC REFERENCES
Full Name of Reference #1*
Department*
How long have you known this person?*
Full Name of Reference #2
Department
How long have you known this person?
Full Name of Reference #3
Department
How long have you known this person?
Describe your schedule for next semester (include classes, clinical, student teaching, internships, etc).*
Please list all extracurricular activities & athletics. (Such as Sports Teams, FCA, One Voice, Miss MHB, etc.)*
COMPUTER SKILLS

Please select your experience level for each.
Microsoft Word*

NoneBeginnerIntermediateAdvanced
Excel*

NoneBeginnerIntermediateAdvanced
PowerPoint/Slide Presentations*

NoneBeginnerIntermediateAdvanced
Microsoft Teams*

NoneBeginnerIntermediateAdvanced
Instagram*

NoneBeginnerIntermediateAdvanced
Canva*

NoneBeginnerIntermediateAdvanced
Have you ever been adjudicated as a juvenile or convicted of or pled "nolo contendere" to a felony or misdemeanor crime?*

NoYes**
**If yes, please explain:
Based on the job description provided to me, I believe that I am able to perform the essential functions of this job, with or without reasonable accommodation.*

YesNo
*I certify that answers given herein are true and complete to the best of my knowledge. In consideration of my employment, I agree to comply with the Employee Statement of Understanding, rules, regulations, philosophy, mission and policies of the University of Mary Hardin-Baylor.

*The University as employer may make the following conditions mandatory: overtime, shift work, rotating work schedules, or a work schedule other than Monday through Friday. I accept these conditions of employment.

*I grant the University of Mary Hardin-Baylor permission to access my academic, employment and personal history (which may include information concerning my character, criminal history, mode of living, general reputation, personal characteristics and related pertinent information). I hereby waive any claim which I might have against any person or entity for information provided.
Signature*

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Date*

MonthDayYear
Date
Application Questions

Please answer the following questions.
1. Why are you interested in being a tutor?*
2. What qualities do you possess that would help you be a tutor?*
3. What advice would you give to freshmen that would help them become successful students?*
4. What are your career plans and how would being a tutor contribute to those plans?*
5. Please fill in the three blanks below to complete the following statement. _________+ __________ + __________ = Success in College*
If you have questions, please contact:

Dawn Bentley, Academic Success Coordinator

dbentley@umhb.edu
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Application for Student Employment

EXPERIENCE

ACADEMIC REFERENCES

COMPUTER SKILLS