Saint Louis University

Last Name:
First Name:
MI:
Social Security #:
Date of Birth:
Email:
Local Address:
(Include dorm room and box # if applicable)
City:
State:
Zip:
Local Phone #:
 
In case of an emergency, please contact:
Name:
Phone #:
Relationship:
Year of School: Freshman Sophomore Junior Senior Graduate
Major:
Est. Graduation Date:
Have you ever worked for Saint Louis University before? Yes No
If yes, which department?
If yes, when?
Are you eligible for college work-study? Yes No
Is it currently being used? Yes No
 
Are you currently licensed?
  Drivers: Yes No
Exp. Date:   State:
  Chauffeurs: Yes No
Exp. Date:   State:
Have you had any traffic violations in the last 24 months? Yes No

If yes, please list what you were cited for:

What experience do you have which may be beneficial to you in the position for which you are applying?

List two references. (Include name, address, and phone #) Please use former employers, NO RELATIVES or PERSONAL FRIENDS. Letters of recommendation are preferred.



What hours are you available to work? (Please check all that apply)
MON TUE WED THR FRI SAT SUN
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