CLAS Dean's Office - Student Worker Application

Please complete this form to the best of your ability and submit.

Name: Name: * First Last
E-Number:
Contact Information
Cell Phone: Cell Phone: * - ### - ### ####
Alternate Phone: Alternate Phone: - ### - ### ####
Preferred Email: *
EIU Email
Local Address: Local Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home/Permanent Address (if different): Home/Permanent Address (if different):
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Declared Major(s) *
Declared Minor(s)
Year in School (Fall 2021): *
Estimated Graduation Date: Estimated Graduation Date: * / MM / DD YYYY
Work History:

In this section, please detail your work history starting with your most recent job first. Please list any skills you may have that you gained during your employment. If you have not had a job previously, please type N/A in the required fields.
Job Title / Company #1 *
Description of Duties: *
Job Title / Company #2
Description of Duties:
Please list any special skills, awards, accomplishments, or other important characteristics about yourself. *
Upload a Resume (if desired):

Attach Files
References

Please list a personal/professional reference that we may contact. These references should not include relatives.
Reference #1 *
Relationship to Applicant: *
Email: *
Phone: Phone: * - ### - ### ####