START Application Form
Please provide all information relevant to your employment below. If you have any questions about START or if you experience any difficulties when completing or submitting this form, please email:
jlk@nebrwesleyan.edu
I. Personal Information
First Name:
Last Name:
SMB:
Email:
Permanent
Address:
City:
State:
Phone:
Current
Address:
City:
State:
Phone:
Major:
Minor:
Graduate Status:
FY
SO
JR
SR
II. Skills & Knowledge
For which position(s) are you applying? (Please check all that apply.)
Mobile Helpline Asst.
Computer Lab Asst.
Reception Area
Network Admin.
Software Support
Hardware Support
System Admin.
Other (specify below...)
Classroom Development
Multimedia Development
Web Development/Support
Rate your level of knowledge & skill on the basis of the criteria and scale that follows. Include a '+' in the rating if you have used the hardware or software application within the past year, or include a '-' in the rating if it has been more than a year since you have used the corresponding application.
0 - Never used; 1 - Have observed app. in use but never used it myself; 2 - Have used app. to complete small tasks; 3 - Have used to complete personal tasks or school assignments at least once per week for at least one semester; 4-Have completed at least one project using several known features of app; 5 - Have completed two or more projects using several known features of the application.
Operating System:
MacOS X
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Windows Vista
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Operating System:
Windows XP
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Linux
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Word Processing/
Spreadsheet:
Microsoft Word
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Microsoft Excel
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Page Layout:
InDesign
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Quark XPress
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Database:
Microsoft Access
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
FileMaker Pro
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Image Editing:
Photoshop
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Fireworks
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Image Editing:
Illustrator
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
GIMP
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Presentation:
Microsoft PowerPoint
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
KeyNote
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Web Authoring:
Dreamweaver
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
FrontPage
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Multimedia:
Adobe Live Motion
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Macromedia Flash
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Video:
iMovie
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Premiere
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Hardware:
Digital Scanner
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Still/Video Camera
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Digital Media:
CD/DVD's
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Acrobat/PDF
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
Others:
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
0
1
2-
2
2+
3-
3
3+
4-
4
4+
5-
5
5+
III. EXPERIENCE
Please list three past work or volunteer experiences and corresponding supervisors that you wish to be contacted as a reference.
Workplace
Job Title/Responsibility
Reference Name
Reference Phone
IV. AVAILABILITY
Please select
"A"
for the times you are
A
vailable and
"A/P"
for the times you are
A
vailable and would
P
refer working. Leave blank if you are unavailable at that time.
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
8:00 AM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
9:00 AM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
10:00 AM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
11:00 AM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
12:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
1:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
2:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
3:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
4:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
5:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
6:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
7:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
8:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
9:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
10:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
11:00 PM
A
A/P
A
A/P
A
A/P
A
A/P
A
A/P
Please list dates and times during which you can be available for a personal or phone interview.
Mondays:
Tuesdays:
Wednesdays:
Thursdays:
Fridays:
V. Additional Information
What is the minimum number of hours per week you would like to work?
What is the maximum number of hours per week you would like to work?
Additional Comments:
By submitting this form, you agree that you have carefully and thoroughly read the application, and that to the best of your knowledge the information you have entered is current and accurate.