Work-Study Application.pdf

[First Name]
- Middle Name: [Middle Name] (if applicable)
- Last Name: [Last Name]
- Title: Mr./Mrs./Ms.
- Student ID #: [Student ID #]
- Telephone #: [Telephone #]
- Street Address: [Street Address]
- Mailing Address: [Mailing Address] (if different than Street)
- City: [City]
- State: [State]
- Zip: [Zip]
- E-mail: [E-mail]

Education:
- Highest School Grade Completed: [Grade Level]
- Earned Equivalent GED: Yes/No

Employment History (Most current to oldest):
- Company: [Company Name]
- Title: [Title]
- Dates of Employment: [Start Date – End Date]
- Business Type: [Type]
- Additional Employment Details (as applicable): Repeat for each previous position.

Current Status:
- Expected Graduation Date: [Date]
- Current Hours Registered: [Number of Hours]
- Current GPA: [GPA]
- Major: [Current Major]

Skills and Qualifications:
- Summarize any training, skills, or experiences that make you suitable for the position, focusing on job-related functions.

Contact Information & Agreement:
- HR Office: Human Resource Office, 1704 Market Street, Room 125, Wheeling, WV 26003, (304) 214-8901
- Affirmative Action/Equal Opportunity Statement: West Virginia Northern Community College is an affirmative action/equal opportunity organization that does not discriminate based on race, religion, national origin, creed, sexual orientation, age, or disability.
- Signature: [Print Form]