APPLICATION FOR WORK STUDY PROGRAM

NAME:

STUDENT ID:

LOCAL ADDRESS:

EMAIL:

PHONE:

MOBILE:

INTENDED MAJOR:

CLASS:

CURRENT GPA:

DEPARTMENT REQUESTED:

Which semester are you requesting employment? (Check all that apply)

JOB SKILLS:

AVAILABILITY:

Receiving Financial Aid?

Eligible for Federal Work Study?

Are you a US Citizen?

If No, can you submit proof of your legal right
to work in the U.S. if you are offered employment?

Proof of citizenship or immigration status will be required upon offer of employment.

Are you currently working on campus?

Are you currently living on campus?

PREVIOUS EMPLOYMENT:

Enter the word you see below in the text box provided:


1100 College Street Columbus, MS 39701phone: 662.329.4750 or 877.462.8439