Attention: Human Resources 1845 N.

Fairmount; Box 56, Wichita, KS 67260-0056

RHATIGAN STUDENT CENTER

Application for Student Employment

myWSU ID: v485u369 Name Date:

GAJULA
Last

SREENIVAS RAO
First

MI

Email Telephone #: Telephone #: ( 316 ) ( )

Wichita Address 1736 N. ROOSEVELT Ct., WICHITA, KANSAS 67208 Home Address B-3,F-3 # of Credit Hours Enrolled Major Minor

708 - 8522
(circle one)

Fresh./Soph./Jr./Sr./Grad. Activities

Place an (X) next to the department of interest: Accounting x Info Center

Bookstore

Gallery

Maintenance

Marketing

Rec Center

Reservations

x
x
Calculator?

Shocker Bowling

Shocker Card Center

Can you operate a: Computer?

List any other skills, qualifications, or work experience that should be considered

no Have you been previously employed by Rhatigan Student Center?_______ If so, when?
Were you employed under a different name? If so, what name? Desired Hours/Week

20 Are you currently employed in any other departments on campus? Yes______No______

If so, what department(s)?

10th February 2012 Date available to work_______________________________

Do you have work study funds? no

Have you ever been convicted of a felony?_________ If yes, describe in full Education High School College Other Military Service Record: Have you served in the armed forces? Yes_____ No_____ Dates List duties in the service including special training
Rev. 10/10 RSC Application for Student Employment

Name and Address of School

Course of Study

Did you graduate?

Sri Chaitanya Junior College- INDIA

JNTU

Maths, Physics, Chemistry

Electrical Engineering

yes
yes

Employment History
(Cover all positions. Show present or LAST POSITION FIRST. Fill out completely.) Employer Name/Address Dates Job Duties Rate of Pay From: Starting: To: Supervisor Name 2. Title From: To: Supervisor Name 3. Title From: To: Supervisor Name 4. Title From: To: Supervisor Name Title Phone #: Phone #: Starting: Final: Phone #: Starting: Final: Phone #: Starting: Final: Final: Reason for Leaving

1.

(Do not list relatives) Name and Occupation Address Phone Number

References

Have you ever been bonded?_____________________ If yes, on what jobs? no May we contact the employers listed above? ____________ If not, which ones do you not want us to contact? How were your referred to Rhatigan Student Center? RSC Employee RSC Website Sunflower ad Self Other (specify below)

The facts set forth in my application for employment are true and correct to the best of my knowledge. I hereby authorize Rhatigan Student Center to conduct inquiries regarding employment history, educational accomplishments, criminal history, credit history, and/or driving history to determine my acceptability for employment. I direct the custodian of these records to release this information to any authorized agent of Rhatigan Student Center. I release any individual, institution, business or organization from any and all liability for damages which might arise from the release of pertinent information. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. Information received by Rhatigan Student Center will be handled confidentially. I further agree to observe all rules, regulations, and policies of Rhatigan Student Center. Date AN EQUAL OPPORTUNITY EMPLOYER

Signature of Applicant Rev. 10/10 RSC Application for Student Employment

Application for: Fall/Spring/Summer

(Circle One)

Year:

Date Phone # Name Address

(City) (State) (Zip)

Email

Please indicate the times and days you have a class with an X. Please indicate times and days you are unavailable to work with an O. BLANK SPACES INDICATE AVAILABILITY TO WORK TIMES.
Monday 7:30 - 8:00am 8:00 - 8:30am 8:30 - 9:00am 9:00 - 9:30am 9:30 - 10:00am 10:00 - 10:30am 10:30 - 11:00am 11:00 - 11:30am 11:30 - 12:00pm 12:00 - 12:30pm 12:30 - 1:00pm 1:00 - 1:30pm 1:30 - 2:00pm 2:00 - 2:30pm 2:30 - 3:00pm 3:00 - 3:30pm 3:30 - 4:00pm 4:00 - 4:30pm 4:30 - 5:00pm 5:00 - 5:30pm 5:30 - 6:00pm 6:00 - 6:30pm 6:30 - 7:00pm 7:00 - 7:30pm 7:30 - 8:00pm 8:00 - 8:30pm 8:30 - 9:00pm 9:00 - 9:30pm 9:30 - 10:00pm
Student Availability Table RSC Logo Rev. 10/06/10 RSC Application for Student Employment Rev. 10-10

Tuesday

Wednesday

Thursday

Friday

Saturday