Name:

Email:
(I acknowledge that by giving the UC my email, it will be added to the UC Student Employee Listserv)

Local Address:

Permanent Address:

Local Phone:

Permanent Phone:

Peoplesoft ID#:

Are you currently eligible for work study?:

Anticipated Graduation Date:

1. Job Preference

(Please identify your areas of job preference in the text box below)

• A.D. Bruce Religion Center
• Audio/Visual Technician (UC Event Services)
• Cashier (UC Business Office, UC Satellite Games Room, UC Games Room)
• Customer Relations Manager (UC Administrative Services and Operations Office)
• Evening/Wknd Supervisor (UC Games Room, UC Satellite Games Room)
• Financial Assistant (UC Business Office)
• Mail Clerk (UC Business Office)
• Maintenance Assistant (UC Building Services)
• Office Assistant (UC Administrative Services and Operations Office
• UC Building Services, UC Creation Station, UC CARS Office)
• Sales Attendant (Shasta's Cones & More)
• Student Graphic Designer (UC Creation Station)
• Student Marketing Assistant (UC Administrative Services and Operations Office)
• Student Mechanic (UC Games Room)
• Technology Support Assistant (UC Technology Support)

2. Please Specify Days / Hours Available to Work

3. Employment / References

Employer:

Supervisor:

May we contact this employer?:

Address:

Telephone:

Dates of Employment:

Employer:

Supervisor:

May we contact this employer?:

Address:

Telephone:

Dates of Employment:

Employer:

Supervisor:

May we contact this employer?:

Address:

Telephone:

Dates of Employment: