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476255715000CALIFORNIA STATE UNIVERSITY, LOS ANGELESSTUDENT EMPLOYMENT APPLICATIONTo be eligible for employment you must be enrolled at least part-time and maintain the minimum GPA.For more information about eligibility and how to apply, visit calstatela.edu/careercenter/plete, save and upload an application to Handshake for each job you apply for.Fields marked (*) are required.* DATE * JOB TITLE * DEPARTMENT FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????PERSONAL INFORMATION* Name Last FORMTEXT ?????First FORMTEXT ?????Middle Initial FORMTEXT ???* CIN FORMTEXT ?????Address Number & Street FORMTEXT ?????Unit # FORMTEXT ?????City FORMTEXT ?????Zip code FORMTEXT ?????Cell Phone FORMTEXT ?????Alternate Phone FORMTEXT ?????E-mail FORMTEXT ?????Are you over 18 years old? FORMCHECKBOX Yes FORMCHECKBOX NoIf no, a work permit may be required at time of hire.If hired, can you provide evidence that you are legally authorized to work in the U.S.? FORMCHECKBOX Yes FORMCHECKBOX No* Do you have any existing CSU employment including UAS, ASI or U-SU? FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, how many hours of work per week? FORMTEXT ?????If you are related to anyone employed by Cal State LA, please provide the following:Name FORMTEXT ?????Relationship FORMTEXT ?????Department FORMTEXT ?????EDUCATIONPost-Secondary EducationMajor/Career GoalFromMo/YrToMo/YrDegree? Y/NLast TermGPA*California State University, Los Angeles FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ??? FORMTEXT ???? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ??? FORMTEXT ???? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ??? FORMTEXT ???? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ??? FORMTEXT ????* In how many units are you currently enrolled? FORMTEXT ????Academic Level FORMCHECKBOX Freshman FORMCHECKBOX Sophomore FORMCHECKBOX Junior FORMCHECKBOX Senior FORMCHECKBOX Graduate SKILLSValid Licenses/Certificates FORMTEXT ?????Keyboarding WPM FORMTEXT ???Office Machines FORMTEXT ????? Computer Programs FORMTEXT ?????LanguagesSpoken FORMTEXT ????? Read FORMTEXT ?????Written FORMTEXT ?????EMPLOYMENT INFORMATION List current position first (Include full-time, part-time, cooperative education, internships, volunteer, summer work and any military service.)Employer Name, City & Phone Number FORMTEXT ?????Position Title FORMTEXT ?????Hrs/Wk FORMTEXT ???From Mo/Yr FORMTEXT ?????To Mo/Yr FORMTEXT ?????Reason for leaving FORMTEXT ?????Job Duties FORMTEXT ?????Continues-931545219710*00*EMPLOYMENT INFORMATION (Continued)Employer Name, City & Phone Number FORMTEXT ?????Position Title FORMTEXT ?????Hrs/Wk FORMTEXT ???From Mo/Yr FORMTEXT ?????To Mo/Yr FORMTEXT ?????Reason for leaving FORMTEXT ?????Job Duties FORMTEXT ?????Employer Name, Address & Phone Number FORMTEXT ?????Position Title FORMTEXT ?????Hrs/Wk FORMTEXT ???From Mo/Yr FORMTEXT ?????To Mo/Yr FORMTEXT ?????Reason for leaving FORMTEXT ?????Job Duties FORMTEXT ?????You may attach a résumé and other additional documentation to this application.May we contact your current supervisor? FORMCHECKBOX Yes FORMCHECKBOX NoIf employed under other name(s), please list: Supervisor name & phone FORMTEXT ????? FORMTEXT ?????Have you ever been discharged from any position(s)? FORMCHECKBOX Yes FORMCHECKBOX No If yes, please explain: FORMTEXT ?????CLASS SCHEDULE (Mark the times that you are NOT AVAILABLE TO WORK)DAY8-99-1010-1111-1212-11-22-33-44-66-8AFTER 8MondayTuesdayWednesdayThursdayFridaySaturdaySundayAre you available to work a night shift if required? FORMCHECKBOX Yes FORMCHECKBOX NoAre you available to work weekends? FORMCHECKBOX Yes FORMCHECKBOX NoAre you available to work a graveyard shift if required? FORMCHECKBOX Yes FORMCHECKBOX NoIf required, do you have a valid CA driver license? FORMCHECKBOX Yes FORMCHECKBOX NoADDITIONAL INFORMATIONBriefly describe your qualifications for the position by virtue of your education, experience and/or interest. FORMTEXT ?????Activities (including honors, clubs, sports, hobbies, etc.) FORMTEXT ?????California State University, Los Angeles is an equal opportunity employer subject to all state, federal and CSU regulations pertaining to non-discrimination based on gender, sex, sexual orientation, race, national origin, religion, disability, marital status, age and veteran status. Upon request, reasonable accommodation will be provided to individuals with protected disabilities to (a) complete the employment process and (b) perform essential job functions when this does not cause undue hardship. ................
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