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GA Application Form
Please Note:
If you resign or are terminated from a student employment position in the Department of Housing & Residence Life you may not apply to work within the department again for another six months.
*
First Name:
*
Last Name:
Middle Name:
*
Street Address:
*
City:
*
State:
*
Zip Code:
(5 digits)
*
Email Address:
(username@yourisp.com)
*
Telephone Number where you prefer to be contacted:
(xxx-xxx-xxxx)
*
Type of phone:
(Select One:)
Cell
Home
Work
Other
EDUCATIONAL BACKGROUND
Name of Undergraduate Institution:
Name of other Undergraduate Institution:
(if applicable)
*
Major Course of Study:
Minor(s):
*
Graduation Date:
(MM/YYYY)
If previously enrolled in a graduate degree program, please complete the following 5 questions:
Graduate Institution(s):
Program of Study:
Dates enrolled:
(MM/YYYY - MM/YYYY)
Degrees sought/obtained:
Graduation Date:
(MM/YYYY)
APPALACHIAN STATE UNIVERSITY GRADUATE SCHOOL INFORMATION
Date Application Submitted:
(MM/YYYY)
Admitted:
(Select One:)
Admitted
Deferral/Waitlist
Incomplete Application
Not Admitted
Other
Department Applied To:
Program of Study:
Degree Sought:
Expected Graduation Date:
(MM/YYYY)
Date of GRE Participation:
(MM/YYYY)
Scores Submitted:
(Select One:)
Yes
No
*
POSITIONS APPLYING FOR
Check all positions for which you wish to be considered:
(CTRL + click for multiple selections)
(Not all positions are available every year.)
ACT Community Outreach Center Manager
Alternative Spring Break & NC-ACTS! Assistant
Appalachian Heritage
Career Development
GA for Community Development
GA for Living Learning Center
GA for Night Stars
GA for RHA Advisement
Graduate Student Mentor
Leadership Education
LGBT Center
Multicultural Popular College Programming
Multicultural Student Development
Outdoor Programs
Outdoor Programs Marketing
Peer Career
Residence Director
Service-Learning & Community-Based Research Assistant
Service-Learning & Community-Based Research Assistant II
Women's Center
*
Authorization for Release of Information
By typing my name on this application below I attest that, to the best of my knowledge, all information provided by me in this application is truthful and accurate. I also acknowledge that I wish to actively pursue a position as indicated on this application and authorize the person(s) conducting said searches to obtain information about me as needed to verify my eligibility for such employment. I understand that this may include contacting references, the release of my student conduct or judicial records from any institutions I have attended and verification of admission to a graduate program at Appalachian State University.
Please copy the word in the above image.