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:

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 Windows XP/7
Operating System: Windows 8 Linux

 Word Processing/

 Microsoft Word  Microsoft Excel
 Page Layout:  InDesign  Quark XPress
 Database:  Microsoft Access  FileMaker Pro
 Image Editing:  Photoshop  Fireworks
 Image Editing:  Illustrator  GIMP
 Presentation:  Microsoft PowerPoint  KeyNote
 Web Authoring:  Dreamweaver  FrontPage
 Multimedia:  Adobe Live Motion  Macromedia Flash
 Video:  iMovie  Premiere
 Hardware:  Digital Scanner  Still/Video Camera
 Digital Media:  CD/DVD's  Acrobat/PDF



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


 Please select "A" for the times you are Available and "A/P" for the times you are Available and would Prefer working. Leave blank if you are unavailable at that time.
   Sunday  Monday  Tuesday  Wednesday Thursday  Friday   Saturday
8:00 AM  
9:00 AM        
10:00 AM        
11:00 AM            
12:00 PM           
1:00 PM        
2:00 PM          
3:00 PM             
4:00 PM          
5:00 PM          
6:00 PM        
7:00 PM            
8:00 PM      
9:00 PM      
10:00 PM        
11:00 PM          

Please list dates and times during which you can be available for a personal or phone interview.






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.