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Eastern Illinois University - Charleston, IL
 
First Name Last Name
OPE Box # E-Mail Address
Local address Local Phone Cell Phone
Home Address Home Phone

I am applying for a position in:
(Please rank in order, 1 being first preference, the job(s) for which you are qualified.)

Residence Halls      Greek Court       University Court/Marketing   Night Assistant Coordinator

University Court/Web Design   University Apartments/Public Relations

Undergraduate Major   Undergraduate Cum G.P.A.   Bachelor's Completion Date
   
Graduate Cumulative G.P.A.(if applicable) Expected Master's Completion Date
Please list colleges attended
Degree You Obtained College/University you attended Dates of Completion
List any work experience relevant to the graduate assistant position.
Company/Organization Dates of Employment Reason for Leaving
Please provide at least one reference who was your direct supervisor
Name Institution/Company Phone E-mail


Please tell us about your involvement in any organizations, clubs, honor societies etc.)


Thank you for completing this application. Please verify all the information is correct. Upon submitting your application there will be additional instructions on the application process.