STUDENT EMPLOYMENT APPLICATION

Please complete the application below, then print out the form and bring it to EMCC's Financial Aid Office.

Name Social Security Number  --

Home Phone  --       Message Phone   --       Best time to call  Anytime Morning Afternoon Evening

Street Address 

City    State    Zip 

                            Work Experience

                            (Paid or Volunteer)

Company #1 Name  

Dates Employed (mm/yy - mm/yy)  -  Job Title  

Brief Job Description:  

 Company #2 Name  

Dates Employed (mm/yy - mm/yy)  -  Job Title  

Brief Job Description:  

Company #3 Name  

Dates Employed (mm/yy - mm/yy)  -  Job Title  

Brief Job Description:  

                                        Skills

Please list all skills and computer software with which you are familiar:

                                    Availability

Days Available:      Mon  Tues  Wed  Thurs Fri  Sat  Flexible

Times Available:     Morning  Afternoon  Evening  Flexible

I certify that the information listed on this employment application is true and correct to the best of my knowledge. I also understand that employment applications may not be kept for more than six (6) months.

Signature of Applicant:  Date: