Student Job Application

(For best results, please fill out this form using the Google Chrome Browser.)

Note: Before beginning work, New Hires must provide Human Resources with a current Social Security Card and any other documents required by law.Financial Aid must pre-approve E&G/Workstudy Employment for each academic year, each summer semester, and each interim period.
Northwestern Oklahoma State University abides by the Drug-Free Workplace laws. Unlawful possession, use or distribution of illicit drugs and alcohol by employees on NWOSU property can result in termination of employment.

Personal Information

Full Legal Name (as shown on Soc. Sec. Card) *

Last 4 digits of Social Security Number

Present Street Address *

City *

State *

Zip Code *

Phone Number *

E-Mail Address *

Emergency Contact

First and Last Name *

Phone Number *

Are you currently a student at Northwestern? *

Do you qualify for *

Applying for Job at *

Department and/or Student Job(s) applying for so this application may be directed to the correct people: *

Are you currently working at Northwestern? *

If yes, in what capacity?

Have you worked for Northwestern before? *

If yes, in what capacity?

List names of any relatives working in the department in which you are applying: *

Have you ever been convicted of or pled guilty to any violation of the law other than for parking or speeding violations *

If yes, describe in full:

Availability for Work

What days/hours of the week are you available for work? *

How many Hours? (Students limited to 15 hours per week.) *

Are you legally entitled to work in the United States? *

Student Class Schedule: List ALL times that you will be in class or otherwise UNAVAILABLE for work. *

Prior Work History

May Northwestern contact your present employer without notifying you first? *

Employers Name/Address (street, city, state, zip code) *

Name of Supervisor *

Your Position/ Job Duties *

Hire Date *

End Date *

Reason for Leaving *

Employer #2's Name/Address (street, city, state, zip code)

Name of Supervisor #2

Your Position/ Job Duties #2

Hire Date #2

End Date #2

Reason for Leaving #2

List any additional experience, skills, or qualifications that could help you qualify for a job with us. (E.g.: Excel, Word, etc.) *

REFERENCES: Please list the names, addresses, and phone numbers of 3 references, excluding relatives and former employers.

3 References (name, then street address, city, state, zip code, then phone number) *

Today's Date *

Terms & Conditions

Check this box as your electronic signature.

Applicant's Statement
I understand that my application will remain active for the current semester and that I should file an updated application with the Career Services Office if I wish to be considered beyond that period of time. All persons, schools, universities, firms and entities listed in this application are hereby authorized to release any information or records concerning my education, academic achievement, attendance, work performance, and personal history for the official use of Northwestern Oklahoma State University. I hereby release said persons, schools, universities, firms, and entities, as well as Northwestern Oklahoma State University and employees thereof from any liability for damage of whatever kind, as a result of furnishing or receiving of such records and information. I certify to the best of my knowledge the facts set forth in my application are accurate and complete. I understand that falsifying information on this application will be sufficient grounds for termination of my employment or cancellation of job offer without notice hereafter.

A copy of this application will be emailed to the email address provided above.