Auxilia ry Services 801 Le roy P lace

Socorro New Mexico 87801

New Mexico Tech

(575) 835-5050

fair {575\ 835-5055


Please type or print neatly

Employment Locations

Check an that interest you Aux i liar y Services Office _ Game Room

Macey Center

Children's Center S\'·,im Center Golf Shop Snack Bar (must be 19) _ Golf Shop Residential Life

Work Stud y (YIN)

Personal Data



First Middle Initial

Date of Birth-------

Current phone n umb er _

urrent addres s

Sex (M /F)

Ema il addre ss. _

C/S Box # or street address Cil} State Zi p

Permanent phone number _

Permanent address

C/S Box # or street address

City State Zip

If you currently live in a residence hall, which one? _


Educational Background

Ma jor

Present Cumulative GPA----

Expected date of graduation _

Continued on Back

Ne\\ Me ico Insutute of Min ing and Technology is 11J1 Equal Opporrunil} Institution

Employment History

List your last three jobs including part-time and summer.

Position Emplover Emplover's Phone # Dates Emgloved

Describe any related work experience that you will bring to the position.

List the hours you would be available to work.



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Organizations and Activities

Please list any outside commitments that you will have, while employed with Auxiliary Services. Include work commitments, memberships in campus or community organizations, student teaching, off­ campus training, internship, etc. Also, indicate the hours required per week for each of these activities.

Act ivit vLEmJllQ.ymenl Hours ger week Activitv/ Em,o!Qyment Hours ger week

List any organizations to which you have belonged to and any leadership roles you have held which you feel have prepared you to be an effective employee.

Ore:anizati_on/L adersh ip Role Organization/Leadership Role

List hobbies and special interests you have.