Summer RA/SYP Counselor Application

Murray State University
Housing/Residence Life
206 Stewart Stadium

Phone #:
270.809.2310

Contact Person:
Derrick McReynolds - Assistant Director for Residence Education
derrick.mcreynolds@murraystate.edu

Term Applying For: Summer 2013

Last Name*

First Name*

Middle Initial

M#*

Email Address*

Cell Phone #*

Date of Birth*

Classification

Other, please specify

Permanent Home Address:*

Local (Murray) Address:*

Please list your previous work experience, beginning with most recent.

#1-Employer

#1-Work Responsibilities

#1-Date of employment

#2-Employer

#2-Work Responsibilities

#2-Date of employment

#3-Employer

#3-Work Responsibilities

#3-Date of employment

Please list any related skills/experiences

Have you ever been convicted of, or entered a plea other than innocent or not guilty, to any crime - including felony or misdemeanor - or are there any criminal charges presently pending against you?

YES

If you answered 'YES', please include an explanation. Please note that additional documentation may be requested. Disclosure of a criminal record or pending charges will not necesssarily disqualify you from employment. Each offense will be evaluated on its own.

Explanation (if applicable)

#1-Name

#1-Position/Organization

#1-Email Address

#1-Phone #

#2-Name

#2-Position/Organization

#2-Email Address

#2-Phone #

#3-Name

#3-Position/Organization

#3-Email Address

#3-Phone #

1) Submitting an on-line application DOES NOT guarantee employment or guarantee the applicant an interview.

2) Every student who is hired by the MSU Housing Office is required to complete a Federal I-9 Form within two business days of being offered employment (available on-line - http://www.murraystate.edu/Campus/Housing).

3) Students who have not been employed by the univeristy (in any capacity) prior to submitting an application must complete a federal background check (available on-line - http://www.murraystate.edu/Campus/Housing).

4) Former employees of the university who have not worked within the last year must complete a federal background check (available on-line - http://www.murraystate.edu/Campus/Housing).

5) Student employment is at will and may be terminated at any time without cause.

I have read and understand the above statements*

The information provided is true to the best of my knowledge*

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