Online Application

Even though this application asks you to name the position that appeals to you most, Pick-Staiger will consider you for employment in a range of positions. At the end of the form, you may name the job areas that interest you most. After submitting this application, Pick-Staiger will send you an e-mail confirming receipt.

Personal Information

Full Name: *

Home Phone:

Cell Phone:

Email: *

Campus Address

Street: *

Additional:

City: *

State: *

Zip Code: *

Home Address

Street: *

Additional:

City: *

State: *

Zip Code: *

Employment Information

Primary Position Applying For: *

Enter the primary position for which you are applying.

Other Positions That Interest You:

List other positions you would enjoy in order of interest (most interested first).

Are you eligible for Work-Study?: *

Yes

Pick-Staiger can only hire work-study employees.

Most Recent Employer

Employer:

City:

State:

Position Held:

Start Date:

End Date:

Reason for leaving:

Supervisor:

Duties and Responsibilities:

Prior Employer (1)

Employer:

City:

State:

Position Held:

Start Date:

End Date:

Reason for leaving:

Supervisor:

Duties and Responsibilities:

Prior Employer (2)

Employer:

City:

State:

Position Held:

Start Date:

End Date:

Reason for leaving:

Supervisor:

Duties and Responsibilities:

Prior Employer (3)

Employer:

City:

State:

Position Held:

Start Date:

End Date:

Reason for leaving:

Supervisor:

Duties and Responsibilities:

Job Skills

Relevant Skills:

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Online Application

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