Student Employment Application
The University of Washington does not discriminate against individuals because of their race, color, creed, religion, national origin, sex, sexual orientation, age, marital status, disability, or status as a disabled veteran or Vietnam era veteran
Personal information
Huang
Last Name
Joanne
First Name MI
1134101
Student ID# UW Undergrad Freshman Junior UW Grad
16
Credits enrolled Sophomore Senior
Spring
Quarter
jhuang20@uw.edu
Email address @u.washington.edu
(503)781-0402
Phone
42325 Haggett Hall
Street Address line 1 Apt. unit, or route number
UW ELP (English Language Program) Other school or program:
Seattle
City
WA
State
98195
Zip
Music
Major
Yes
No
Work Study award?
Current and future work availability
Mark the times you are in class or unable to work for the quarter:
MON TUE WED THU FRI SAT SUN
AUT
WIN
SPR
SUM
5:00- 7:30- 8:30- 9:30- 10:30- 11:30- 12:30- 1:30- 2:30- 3:30- 4:30- 5:30- 6:30- 7:30- 8:30- 9:30- 10:30- 11:30- 12:307:30 8:30 9:30 10:30 11:30 12:30 1:30 2:30 3:30 4:30 5:30 6:30 7:30 8:30 9:30 10:30 11:30 12:30 3:00 x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x
x x
x x x
03/26/2012
Able to work from (mm/dd/yyyy)
06/01/2012
Able to work until (mm/dd/yyyy)
Available Summers?
Position for which you are applying
Job Title
Student Technician
Library Cashier
Unit / Department
Experience
Please indicate your previous voluntary or paid work experience. You may also attach a resume.
Organization or Company Name
Legacy Health Systems
Position / Job Title Phone Number
In-Patient Volunteer
City and State
Portland, OR
Supervisor's Name Description of Duties:
Larry Hansen
(503) 244-7890
07/01/2008
Start Date (mm/dd/yyyy)
06/30/2011
End Date (mm/dd/yyyy)
Volunteer Experience: Required a number of tests and
Continue on next page / reverse
Experience (continued)
Organization or Company Name Position / Job Title City and State
Supervisor's Name Description of Duties:
Phone Number
Start Date (mm/dd/yyyy)
End Date (mm/dd/yyyy)
Other Skills
Use this section to list any additional skills, relevant course work, or specific interest in the position you are applying for that you would like to mention. You may also list any additional references or advisors.
Very proficient with Microsoft Office,
Certification and Eligibility
Federal regulations require that your present proof of your eligibility to work in the United States. A drivers license, Social Security Card and student identification card are acceptable verification. Please bring these or other documents with you to your interview. Other documents which may be used include: Passport, Student Visa, Permanent Resident Card, Alien Registration Card, U.S. Military Card. By submission of this application you indicate agreement with the following terms. Acceptable certification is your signature or online submission using your UWNetID. I certify that during the academic quarters in which I am enrolled as a student at the University of Washington, I will not accept a regular campus employment schedule of more than 19.5 hours per week. I hereby allow the University of Washington to make inquiries into records relating to my experience. I understand that consideration of this application and the continuation of any subsequent employment depends upon the truth and accuracy of this information.
03/23/2012
Signature (No signature needed if submitted online using your UWNetID login)
Date (mm/dd/yyyy)
Note: Employment is offered on a quarter by quarter basis and may be extended.
Office use only
Received by _______________________________ Date ______________ Applicant contacted by _______________________ Date ______________ Response __________________
StudentApplication.pdf Rev. 09/17/2009
