CASA Tutor / SI Leader at IPFW CASA

First Name *

Last Name *

Primary Phone Number *

IPFW Email Address *

Student ID Number *

Current Local Address *

City *

State *

Zip Code *

I am 18 years of age or older *

Do you currently work on campus in another department? *

If yes, Please provide the department name, your direct supervisor, and the average number of hours you work per week: (Mention all your current positions)

Class Standing *

What is your anticipated graduation date? *

What is your current IPFW Cumulative GPA? *

Which position(s) are you interested in working? *

Tutor
SI Leader

What is/are your academic major(s) and/or minor(s)? *

Are you a citizen or legal resident of the United States? *

If NO, are you in the country on a: (Should we decide to provide you an employment opportunity, you must obtain an On-Campus Employment Authorization Form from the Office of International Education (Walb Room 145). This form allows you to work on campus for up to 20 hours per week while school is in session, and up to 40 hours during official school vacation periods only.)

Have you been approved for Federal Work Study Money? *

If yes, Have you accepted your Federal Work Study award money?

If yes, Date Work-Study award Accepted

Have you ever been terminated from an IPFW employee position? *

If Yes, Please Explain:

Please list undergraduate course(s) you are interested in supporting. (Format: Course Name/Number - Instructor - Your Grade in that Course - Semester you took that course) *

Do you have previous teaching or tutoring experience?

Are you bilingual? *

If yes, what languages?

How many hours a week would you prefer to work? *

Resume (If you are unable to submit your resume electronically, please submit a paper copy to the CASA office in Kettler Hall Room G23.)

Unofficial Transcript (Unofficial transcripts are free of charge and can be obtained through the Registrar's Office in Kettler Hall. If you are unable to submit your transcript electronically, please indicate when you will submit the paper document when contacted by a CASA staff member regarding your application.)

Instructor Recommendation (*If you are unprepared to submit the document at this time, please be aware that it is part of a complete application for these positions, and a complete application is required before you will be considered for the Tutor/SI positions. Please indicate when you will submit the document when contacted by a CASA staff member regarding your application.)

Work Experience (Mention Company Name, Working Period, Job Title, Job Role, and the Reason for Leaving)

Have you ever been convicted of a crime? (Include court-martial convictions, but exclude minor traffic violations) *

If Yes, Please list dates, charges, place, court, and action taken:

Please provide any additional information you would like to share with us.

I understand that employment in certain jobs at IPFW is conditional upon a review of criminal conviction records, and I authorize the university to request and obtain a Criminal Convictions Report as necessary. I understand that employment at IPFW in jobs that work with or around children (under 18) is contingent upon compliance with Zachary's Law and a review of the Indiana Sex Offender Registry *

I understand some positions may require my involvement with confidential records and confidential information. With this in mind, I will be required to maintain strict discretion and confidentiality. If employed, I will be subject to and agree to comply with policies, rules, and regulations of the University. *

I understand that any false statements by me, or failure to provide any material information requested will be cause for rejection of my application or dismissal from any subsequent employment. I signify my understanding and acceptance by checking the appropriate answer below. *

See all the jobs at IPFW CASA here: http://casaipfw.recruiterbox.com/jobs

Application Form