STATE UNIVERSITY OF NEW YORK AT NEW PALTZ

DEPARTMENT OF ATHLETICS, RECREATION & INTRAMURALS

STUDENT EMPLOYMENT APPLICATION- EQUIPMENT ROOM SUPERVISOR

2009-2010

 

 

Personal Information:

Name:                                                                                       

Local/Campus Address:                                                                                                                        

E-Mail Address:                                                                                                                                    

Best Number to Reach You:                                                         Best time to call:                                    Permanent Address:                                                                                                                                      Phone Number:                                                           

Term(s) applying for: Fall _____      Spring _____      Academic Year _____      Summer _____

Major:                                                                           Minor:                                                               Approximate GPA:                                                 Expected Graduation Date:                                             Are you eligible for Federal Work Study (FWS)?     Yes ______      No ______

Are you a student-athlete?                                   Yes ______      No ______

            If yes, what sport(s)?                                                                                                      

Previous Work Experience:

Have you worked in the Athletic Department before?       Yes ______      No ______

            If so, what position?                                                                                                      

In chronological order, list jobs you have held beginning with the most recent.  Attach another sheet if necessary.

ON-CAMPUS Employment

Job Title:                                                                       Department:                                                     

Supervisor:                                                                    Dates Employed:                                              

 

Job Title:                                                                       Department:                                                     

Supervisor:                                                                    Dates Employed:                                              

(continued on back)

 

 

 

 

 

 

 

 

Relevant work certifications:

Check off current licenses or certifications that you currently hold:

 

q       CPR                             Date of Card Expiration__________________

q       Lifeguard Training         Date of Card Expiration__________________

q       First Aid                        Date of Card Expiration__________________

q       WSI                                Date of Card Expiration__________________

q       AED                               Date of Card Expiration__________________

q       Personal Trainer

q       CSCS

q       Other                                                                                       

 

Briefly discuss any relevant experience that you have that qualifies you for the position you seek:

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       

I certify that the information provided on this application for employment is complete, factually correct, and honestly presented.  I understand that this document is an application for employment, separate and apart from my permanent educational record and is for the use of the Department of Athletics, Recreation and Intramurals.  In consideration for my employment, I agree to conform to all current and subsequent rules and regulations of SUNY New Paltz and the area for which I will be working.

 

Signature                                                                                               Date                                        

For Department Use Only

Interviewed?      Yes ­______      No ______     

            If no, reason:                                                                                                                            

Hired?               Yes ­______      No ______     

            If no, reason:                                                                                                                            

Area Appointed:                                                            Supervisor:                                                       

Appointment Date:                                            Pay Rate:                                  

(Please attach copy of work schedule)