Work-Study Interest Form
Sign in to Google to save your progress. Learn more
Full Name *
Camp Email Address *
First four of your Student ID Number *
Daytime Phone Number *
Evening Phone Number *
Date Available to Start *
Days/Hours Available *
Program of Study (major) *
GPA *
Preferred Type of Employment (if any) *
Preferred worksite (check all that apply) *
Required
Special Skills *
Previous Supervisor
Clear selection
Company Name
Phone #
Current Supervisor
Company Name
Phone #
Duties Performed
Personal Reference (not family) *
Phone *
Personal Reference (not family)
Phone
CERTIFICATION—Each Application Requires Current Date and Original Signature
I herby certify that all entries and attachments are true and complete, and I agree and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part of any employment in the service of Camp. I understand that all information on his application is subject to verification and I consent to criminal history background checks. I also consent that you may contact references and former employers listed regarding this application. I further authorize Camp to rely upon and use, as it sees fit, any information received from such contacts. Information contained on this application may be disseminated to other parties on a need-to-know basis. I have filed the Free Application for Federal Student Aid (FAFSA) for this year.

The Commonwealth of Virginia requires all Executive Branch employees, including new hires, rehires or transfers to disclose their vaccination status upon hire. Disclosure of vaccination status (and for those fully vaccinated, proof of vaccination) will be required during new employee orientation on your first day of work. If you are not vaccinated for any reason or choose not to disclose your vaccination status, you will be required to be tested for COVID-19 once per week on an indefinite basis. If you have questions, please contact the Human Resource Office.
I have read and understand *
Required
Signed *
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy