Name ___________________________ Local Phone Number _______________
 

Local Address _____________________________________________________
 

Permanent Address _________________________________________________
 

Permanent Phone Number ___________ Do you have a vehicle? ____________
 

What is your major? ________________ Student Classification? ____________
 

Date of Birth _______________________ Have you taken FACS 230? _______
 

What, if any, other foods/nutrition classes have you taken? _______________
 

_________________________________________________________________
 

There are 8 to 15 hours per week available and required for this position.

Is this too few hours, too many hours, or just fine? ______________________
 

Work Availability Schedule
Please indicate all times that you are available to work by placing an "X" in the appropriate time slot for each day. If your schedule is identical each day, then indicate this by writing "SAME" or "SAME as MONDAY"/"SAME as TUESDAY" for your school schedule.