First Name    Last Name    Social Security Num.

Street Address    City        State      Zip Code

Telephone #    Email    Cellular #

    I am a new student, never participated in Federal Work Study Program at FIU 

    I participated during 2002-2003 Academic Year and I wish to be placed at a different location

    If you were employed in the 2002-2003 Academic Year and wish to return to the same JOB You do not  need to complete this form. Please notify your supervisor.

    Major                                      Classification    Please Select One Freshmen Sophomore Junior Senior Master Ph.D.

Skills/Qualifications:

Word processing                    Customer Service            Typing

Excel                                      Phones                            Drivers Lic

MS Access                            Filing                                Lifting

Web Page Development        Photo Copying                  General Computer Knowledge

Other Skills please type:

 Enter a number 1,2 or 3 on the options below to indicate your order of preference:

      America Reads Program , transportation required

    Community Service     On Campus    Off Campus

        Would you like to work with any special groups? (i.e. elderly, youth, disabled etc.)

        Please indicate location preference (North, South, Downtown, Broward etc.)

    Federal Work Study (On Campus) University Park Campus    Biscayne Bay Campus