Application for Student Work Study
This application is for participation in the Student Work Study program at Emmanuel College.

Please note that some positions have specific requirement which must be met in order to be considered. If you have questions, please do not hesitate to contact the Emmanuel College Work Study Coordinator, Lucinda James, at ljames@ec.edu.

Email address
Name: (Last or Given)
Your answer
Name: (First)
Your answer
Name: (Middle)
Your answer
Nickname: (I prefer to go by...)
Your answer
Home Address: (Street)
Your answer
Home Address: (City/State/Zip)
Your answer
EC Email:
Your answer
Alternate Email:
Your answer
Cell Phone No.: (xxx) XXX-XXXX
Your answer
Where will you live while enrolled at EC?
What is your major?
Your answer
I would like to apply for the following position(s):
1st Position Choice
2nd Position Choice
3rd Position Choice
4th Position Choice
5th Position Choice
Special Skills: (check all that apply)
Employment History
Begin with your present/most recent employment and work your way back.
Employer #1:
Your answer
Job Title:
Your answer
Approximate number of hours worked per week:
Your answer
Dates of Employment:
Your answer
Description of Duties
Your answer
Employer #2
Your answer
Job Title:
Your answer
Approx. number of hours worked per week
Your answer
Dates of Employment:
Your answer
Description of Duties:
Your answer
List any volunteer organizations or activities in which you have been involved:
Your answer
Authorization to Release Student Information:
I hereby authorize the Work Study Placement Office at Emmanuel College to release, on my behalf to prospective employers my grades, transcripts, and other such information contained in my education records as is necessary to aid employers in assessing my potential for placement in a work study position.

I understand this information will be disclosed to those persons with the employer's organization who have been determined by that organization to have a need to know. I understand that this information is being released pursuant to Section 438(B)4(B) of the Family Educational Rights and Privacy Act of 1974 and will not be released to other parties without my consent.

I have read the statement above and understand I must indicate below in order for my information to be released to prospective employers:
Please complete the captcha before submitting the form.
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