LCSC Work Scholars Application

LCSC Work Scholars Application Application Deadline: October 27, 2017 Send completed applications and resumes to [email protected]

Applicant Name (please print): ______

Application Check List  My application was completed with 12 point font (Handwritten applications or applications using other font sizes will not be accepted.)  My resume was submitted to [email protected] with applications by deadline.  My FASFA is current and up-to-date. (please check with the financial aid office to be certain that your FASFA is current. If we are unable to determine your eligibility for the program because your FASFA is not current your application will not be considered) o For information about completing FASFA: http://www.lcsc.edu/financialaid/fafsa/ o For help and assistance contact Financial Aid: (208) 792-2224, RHC 110

By signing this, I affirm that the above application check list is complete. I have submitted documentation to the appropriate persons. If these documents are not received by the LC Work Scholars Office by the deadline noted above, then I understand my application will not be complete and not considered.

Signature: ______Date: ______

of 6 APPLICANT INFORMATION

Name: ______ID Number: ______

Address: ______

City: ______State: ______Zip: ______

Phone: ______LCSC E-mail: ______

Major: ______Enrollment Status: Full-time Part-time

Number of college credits earned to date: ______Current cumulative GPA: ______

Academic Advisor: ______

Languages other than English: ______Fluency: ______

Military Service (Complete if you have served in the Armed Forces)

Branch of Service ______

Dates of Service: From ______To ______

of 6 Motivation - Please limit response for each question to 500 words or fewer. Attach a separate page if necessary.

Explain your reasons for wishing to be a member of the Work Scholars program.

What do you hope to learn from your employment? Describe the type of work desired and why.

Explain what you have to offer a potential employer.

Indicate days and hours you expect to be available for work (minimum 10 hours per week during academic year).

of 6 Skills and Experience Indicate the specific work skills you possess and how you acquired those skills (check all that apply). This information will allow us to assess job placement options and training needs.

Customer Service _____ Basic Computer _____ Accounting _____

Public Speaking _____ Childcare _____ Retail _____

Microsoft: Computer Skills: Office Skills Word _____ Excel _____ Troubleshooting _____ Telephone _____ Copy/Fax ____ PowerPoint _____ Outlook ____ Web Development/Design _____ Keyboarding _____ wpm____ Access _____ Publisher _____ Filing _____ Other software _____

Oral Communication ______Written Communication ______Shop Safety Procedures _____

Electrical System Repairs _____ Basic Engine Diagnostics _____ Parts Inventory Maintenance ____

Equipment Safety Inspections Teamwork _____ Time Management ______

Workplace Safety _____ Safe and Appropriate Use Other: _____ of Tools _____

of 6 Provide the following information for current and previous employers. Please include a copy of your current resume.

Name of Employer: ______

Employer Address: ______

Supervisor Name: ______

Employed From (MM/DD/YY)______To (MM/DD/YY) ______

Job Duties: ______

______

May we contact this employer? Yes ______No ______

Job Duties: ______

______

Job Duties: ______

______

If you need space for additional employers, please attach separate sheet with the required information.

Acknowledgement Page 5 of 6 The information I have provided in this application for LC Work Scholars is true, correct and complete. False, incomplete, or misrepresented information of any kind, will be sufficient cause for my application to be rejected, or, if discovered after I am employed, cause for immediate termination of my employment. This application is not an employment agreement. I understand that if accepted as a Work Scholar I agree to abide by all program and College policies and procedures or changes therein.

All Work Scholars are subject to the successful completion of a criminal background check.

Signature: ______

Date: ______