University of Southern Maine

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Name

Address
City State Zip

Phone

Email

1.Do you have Federal Work-Study Money? Yes No Don't Know
What is the amount of your workstudy award?

2. What is your program major?

3. Were you previously employed in a work-study position? Yes No

When? Where?

4. What skills do you have that might be used in your preferred employment?

5. Have you taken a computer course? Yes No

6. Office & Other Experience:

Word Processing Filing Customer Service

Spreadsheet Answering Phones Photocopying

Fax Machine Cash Register/Cash Handling

7. What other strengths do you have that might be of interest to an employer?

8. How many hours per week are you available for Work Study employment?

9.. What hours are you able and willing to work? Click Here for Department Hours

Available Hours:

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Class Schedule

Monday
Tuesday
Wednesday
Thursday
Friday

10. Is there any other information about yourself you would like a prospective Work-Study employer to know?

11. Please list 3 persons who could serve as employment-related references:

Name Phone

Name Phone

Name Phone