Summer Employment Application

Name: *

Telephone:

Street Address:

City:

State:

Zip Code:

Birthdate (If under 18 years of age):

Email: *

Are you a student at Cornell?: Yes No

Are you a dependent of a current Cornell employee?: Yes No

If yes, enter name of employee:

Are you returning to Cornell next year?: Yes No

Are you legally eligible for employment in the United States?: Yes No

Pursuant to the Immigration reform and Control Act of 1986, all applicants, upon being made an offer of employment must produce documents which are specified by the federal government, establishing their identity & authorization for employment in the United States. These documents must be produced no later than seventy-two (72) hours after beginning paid employment. You will also be required to sign Form I-9 (issued by the federal government) verifying, under oath, your employment verification.

What position(s) do you seek? Please list in priority order.

First choice:

Second Choice:

Third Choice:

Fourth Choice:

Related skills:

Education (please select highest level completed):

Major:

School activities:

Previous employment (include Cornell work study)

First employment:

Employer:

Address:

Title:

Start Date:

End Date:

Contact Information:

May we contact this employer?: Yes No

Second employment:

Employer:

Address:

Title:

Start Date:

End Date:

Contact Information:

May we contact this employer?: Yes No

Third Employment:

Employer:

Address:

Title:

Start Date:

End Date:

Contact Information:

May we contact this employee?: Yes No

Personal References

First reference:

Name:

Relationship:

Address:

Phone:

Email:

Second reference:

Name:

Relationship:

Address:

Phone:

Email:

Third reference:

Name:

Relationship:

Address:

Phone:

Email:

The facts set forth in my application for employment are true and complete. I understand that if employed, false statements or omission of pertinent information on this application shall be considered sufficient cause for dismissal. I understand that this employment application is for temporary summer work only and that preference will be given to students of Cornell College. I understand that my employment at Cornell College would be “at-will” and could be terminated at any time by either party.: * Yes

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Summer Employment Application

Previous employment (include Cornell work study)

Personal References

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