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Forms Manager
csbsecurity Position
Today's Date:
First Name:
Middle Name:
Last Name:
Date of Birth:
Address:
City:
State or Country:
Zip Code:
Home Phone:
School Address - Residence Hall & Room Number:
Phone:
P.O. Box:
Year in School:
First Year
Sophmore
Junior
Senior
State/Country of Drivers License Issue:
Have you ever been convicted of a criminal offense or had an underage consumption violation?
Yes
No
If yes, please explain:
Are you currently eligible for a full work award?
Yes
No
If no, please explain:
Will you be attending classes on campus both semesters next year?
Yes
No
If no, please explain:
Student security officers are regularly required to work nights and weekends, would this be a problem for you?
Yes
No
If yes, please explain:
Are you interested/available to work during the summer?
Yes
No
Are you interested/available to work during breaks?
Yes
No
Do you hold a current certification in CPR?
Yes
No
Do you hold a current certification in Basic First Aid?
Yes
No
Previous CSB/SJU Student Employment
1) Job Title:
Department:
Supervisor:
Please give a brief description of duties and responsibilities:
2) Job Title:
Department:
Supervisor:
Please give a brief description of duties and responsibilities:
Previous Employment History
Please give a brief description of duties and responsibilities:
Educational and Personal Goals
Educational:
Personal:
Please tell us why you believe you would be an asset to the Department of Security:
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