Personal Information

First Name
Last Name
Telephone
Cell Phone
Email
Address
City
State
Zip

Job Information

Position Applied For
Date Available

Are you currently employed at NYU?
yes
no

Are you a student at NYU?
Full time
Part time
Not a student

Have you applied to the Athletic Department before?
yes
no

Availability
Select preferred location for employment:

	Coles Sports Center 181 Mercer Street New York, New York 10012
	Palladium Athletic Facility 140 East 14th Street New York, New York 10003

Please indicate for each day of the week your availability:

Monday	All DayMorningAfternoonEveningNot Available
Tuesday	All DayMorningAfternoonEveningNot Available
Wednesday	All DayMorningAfternoonEveningNot Available
Thursday	All DayMorningAfternoonEveningNot Available
Friday	All DayMorningAfternoonEveningNot Available
Saturday	All DayMorningAfternoonEveningNot Available
Sunday	All DayMorningAfternoonEveningNot Available

Skills
Please check the appropriate boxes:

Lifeguard	First Aid
Typing WPM:	Word Processing
Database Application	Driver's License
Water Safety Instruction	Spreadsheet
CPR	Other Certifications

How were you referred to NYU?