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On-Campus Student Employee Application

New York University is committed to a policy of equal treatment and opportunity in every aspect of its relations with its faculty, students, and staff members, without regard to age, citizenship status, color, disability, marital or parental status, national origin, race, religion, gender, or sexual orientation, or any other protected status.

University ID Number
NetID
First Name
Last Name
Middle
Cellular Phone
NYU School
Degree Pursuing
Graduation Date
Currently Applying for America Reads / America Counts?	Yes No

Local Address

Address
City
State
Zip

Permanent Address

Select check box if your permanent address is the same as your local address

Address
City
State
Zip

List current and past NYU part-time positions (within the last 3 years)

NYU Department	Start Date	End Date

Student Agreement

I understand that a change in my student status can affect the terms of my employment. If my student status or Federal Work Study Program award changes while employed at NYU, I will inform my supervisor.