Student Application Form

Cornell University Cornell University Library

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ASTech Student Assistant Application Form

Name:

Email address:

Local Phone Number:

Local Address:

Permanent Address:

Birthday, if under 18 years:

Are you a U.S. citizen?:

Yes

If "no" enter visa type:

Expected graduation date:

Are you currently registered?:

Yes

If "no" explain your situation:

Funding

Check any funding sources:

No Funding

Federal Work Study

Tradition

COSEP

Foreign Student Assistance Award

RCPRS

Develop Your Own Internship (summer program)

Enter amount of funding, if known:

Libraries

You may apply to multiple libraries, or just one; please refer to the library map and library hours (Engineering hours, Math hours, Physical Sciences hours).

Libraries:

Engineering

Mathematics

Physical Sciences

Hours Available

Please indicate the times you would be able to work for each day, given your class schedule and other commitments. Shifts are usually 2 - 3 hours in length, but may be shorter or longer. You may work more than one shift per day, or at more than one library. Attendance Requirements: The job term is through the final day of the exams period (see academic year calendar).

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

Position

How did you learn about this position?:

Date available:

Number of hours desired per week:

Cornell Work Experience

For each job include your job title, department name, dates of employment, your supervisor's name, and reason for leaving.

Cornell Job 1:

Cornell Job 2:

Non-Cornell Work Experience

For each job, include your job title, the organization name, dates of employment, and reason for leaving.

Non-Cornell Job 1:

Non-Cornell Job 2:

Other Experience

Please list any additional volunteer experiences or skills or training that you would like to share.

Volunteer Experience:

Education, Training, Skills:

References

Please include the name and contact information for three people, not family member or personal friends, who have knowledge of work experience and/or education.

Reference 1:

Reference 2:

Reference 3:

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