Student Employment Application

Production Technical Student Usher Corp Ticket Office Part-time

Semester:	Fall ____	Spring ____	Summer ____

Student Information	Name - Last, First, Middle JAG Number
Cell phone number Alternate number Date of Birth
Jaguar e-mail Personal e-mail
Local address – Street, City, State, Zip code
Permanent address, Street, City, State, Zip code
Classification Junior Sophomore Graduate Freshman Senior

Work Experience	Employer	Supervisor	Phone	Job Responsibilities

Schedule Availability	Can Work (state times)	Cannot Work (state times)
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Acknowledgement: I understand for employment I must be enrolled in 6 undergraduate hours or 8 graduate hours at the University of South Alabama. Additionally, I must also submit a printed copy of my current class schedule.	I certify the information provided is correct

and true to the best of my knowledge.

____________________________________ __________

Student Name (printed)	Date

____________________________________	__________	Student Name (signed)	Date