Personal Information First Name Last Name Email Phone Number Permanent Address Local Address Student Information Are you currently enrolled? Yes No Current Year Freshman Sophomore Junior Senior Major Units/Qtr Graduation Date Are you eligible for work study? Yes No Background Information Have you ever been employed at UCSB? Yes No If yes, when and where? Are you currently employed at UCSB? Yes No If yes, what department? Have you ever filled out an application here before? Yes No If yes, provide the date Are you prevented from being lawfully employed? All employees must present proof of citizenship or immigration status upon employment Yes No What date can you begin work? How many hours are you in interested in working each week? Are you willing to work weekends? Yes No Are you willing to work over school breaks? Yes No Which job/s are you applying for? Which skills, mentioned in the job description, do you possess? Why are you interested in this position? List any relevant experience or qualifications you can contribute. How did you learn about this position? Work History Job 1 Company Info 1. Employer Address Supervisor Info Supervisor's Name Supervisor's Phone Number Employment Dates Employer Info Pay Rate Job Title May we contact this employer? Yes No Work Experience Work Performed Reason for Leaving Job 2 Company Info 2. Employer Address Supervisor Info Supervisor's Name Supervisor's Phone Number Employment Dates Employer Info Pay Rate Job Title May we contact this employer? Yes No Work Experience Work Performed Reason for Leaving Add a Resume Upload Upload requirementsOne file only.5 MB limit. Personal References Reference 1 1. Name Phone Occupation Email Reference 2 2. Name Phone Occupation Email Availability Quarter and Hours Quarter Desired Hours Per Week Work Schedule UCen work hours vary according to job position. Please fill out the times you will be in class. Once you select a time, it cannot be undone. Monday 5:00am 6:00am 7:00am 8:00am 9:00am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm Tuesday 5:00am 6:00am 7:00am 8:00am 9:00am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm Wednesday 5:00am 6:00am 7:00am 8:00am 9:00am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm Thursday 5:00am 6:00am 7:00am 8:00am 9:00am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm Friday 5:00am 6:00am 7:00am 8:00am 9:00am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm Saturday 5:00am 6:00am 7:00am 8:00am 9:00am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm Sunday 5:00am 6:00am 7:00am 8:00am 9:00am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm Submit