EMPLOYMENT APPLICATION

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EMPLOYMENT APPLICATION

COMPUTER PROFESSIONAL INTERNSHIP PROGRAM

CENTER FOR INFORMATION RESOURCE MANAGEMENT

PERSONAL DATA

Applicant’s Name (Mr/Ms) Social Security Number Application Date
Address (Street/Box, City, State, Zip)
Home Phone Office Phone or Fax E-mail Address # of hours/week you can work?
Languages Spoken/Written US Citizen? Work Permit? When can you start?

EDUCATIONAL DATA

Current University/College Major Department Option/Specialization Degree/Objective
Expected Graduation Date Units Remaining Previous Degree
Overall GPA GPA in Major What areas of IT do you have special interest?
Technical Certifications( for example, certified network engineer )

WORK EXPERIENCE

FIRM

FUNCTION/TITLE

FROM/TO

HOURS/WEEK

a a a a
a a a a
a a a a

INFORMATION TECHNOLOGY COURSE WORK

NUMBER

COURSE TITLE

GRADE

NUMBER

COURSE TITLE

GRADE

a a a a a a
a a a a a a
a a a a a a
a a a a a a
a a a a a a
a a a a a a

I certify that the above is true: _____________________________________________________________ Date: ________________