UREC Application
UREC Application
Please Circle the Semester Applying for: Fall Spring Summer#1 Summer#2
I. PERSONAL INFORMATION
Name:
Last First Middle
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Please list any injury, illness or medical condition, which might require treatment:
Phone:
Phone:
Phone:
III. CERTIFICATION(S): (i.e. CPR, First Aid, Group Fitness, Personal Training . . .):
***PLEASE ATTACH RESUME IF AVAILABLE OR A LIST OF QUALIFICATIONS AND REFERENCES (including email
address)
University Recreation is an Equal Opportunity Employer. It is our policy to make all personnel decisions without discriminating on
the basis of race, color, creed, religion, sex, physical disability, mental disability, age, marital status, sexual orientation, citizenship
status, national or ethnic origin, and any other protected status.
Name: Date:
Minimum # of hours you are requesting: Maximum # of hours you are requesting:
The following availability is for (Please Circle): Fall Spring Summer#1 Summer#2
Please check the times below that you ARE AVAILABLE to work each day: