AGS 2013 Staff Application Survey

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1. Name

Name Last Name
First Name

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2. Gender

Gender Male

Female

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3. Birth Date

	MM		DD		YYYY
Please enter your birth date.	Birth Date Please enter your birth date. Month	/	Day	/	Year

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4. Email Address (please review for accuracy)

Email Address (please review for accuracy)

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5. If hired, an employment package will be mailed at the beginning of May. Please list the appropriate address for that mailing.

If hired, an employment package will be mailed at the beginning of May. Please list the appropriate address for that mailing. St. Address or PO Box
City
State
ZIP Code

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6. Permanent Address (please do not use a college address)

Permanent Address (please do not use a college address) Permanent St. Address or PO Box
City
State
ZIP Code

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7. Phone Numbers

Phone Numbers Cell Phone
Home Phone

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8. AGS Employment


Last Year Employed by AGS	AGS Employment Last Year Employed by AGS

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9. Alumni Status


Are you an alumni of AGS? If so, what year did you attend?	Alumni Status Are you an alumni of AGS? If so, what year did you attend?

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10. Level of Education


Education	Level of Education Education

Other (please explain)

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11. Educational Background

Educational Background Institutions and Years Attended
Current Major

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12. Employment Information

Employment Information Current Position
Company/Employer
Location
Supervisor
Supervisor's Phone Number

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13. Please list three professional references, including their positions and phone numbers.

Please list three professional references, including their positions and phone numbers. Reference 1
Reference 2
Reference 3

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14. Position Desired

	First Choice	Second Choice
Position	Position Desired Position First Choice	Second Choice

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15. State your qualifications and reasons for seeking Choice Number 1. Include any past work or volunteer experience that would enhance your ability to do the job.

State your qualifications and reasons for seeking Choice Number 1. Include any past work or volunteer experience that would enhance your ability to do the job.

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16. State your qualifications and reasons for seeking Choice Number 2. Include any past work or volunteer experience that would enhance your ability to do the job.

State your qualifications and reasons for seeking Choice Number 2. Include any past work or volunteer experience that would enhance your ability to do the job.

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17. AGS is a "round-the-clock" program. Faculty and staff are expected to get involved outside the classroom. Give some examples of evening or weekend activities, programs, games, or events that you would be interested in planning and hosting. Activities from previous years can be found on our website.

AGS is a "round-the-clock" program. Faculty and staff are expected to get involved outside the classroom. Give some examples of evening or weekend activities, programs, games, or events that you would be interested in planning and hosting. Activities from previous years can be found on our website.

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18. I will be available for full-time employment for six days of Orientation (June 5 - 8) and six weeks of AGS (June 9 - July 20). I understand that there are also regular required events occurring during evenings and on weekends.

I will be available for full-time employment for six days of Orientation (June 5 - 8) and six weeks of AGS (June 9 - July 20). I understand that there are also regular required events occurring during evenings and on weekends. Yes

No

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19. Finalists will be notified by the end of March. Interviews with in-state candidates will be conducted in Conway on Saturday, March 30, 2013 in the Student Life & Technology Center, Room 105. Phone interviews with out-of-state candidates will be conducted on the same day.

Finalists will be notified by the end of March. Interviews with in-state candidates will be conducted in Conway on Saturday, March 30, 2013 in the Student Life & Technology Center, Room 105. Phone interviews with out-of-state candidates will be conducted on the same day. I will be available to come to Conway for an interview.

I need a phone interview.

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20. Where did you hear about this opportunity? Please check all that apply.

Where did you hear about this opportunity? Please check all that apply. AGS website

colleague

college career services office

Department of Education website

Facebook or similar online social network

friend

newspaper ad

online forum

school

Other

Other (please specify)

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21. By typing your name and today's date here, you agree that all information is truthful to the best of your knowledge and that you wish to submit your application.

By typing your name and today's date here, you agree that all information is truthful to the best of your knowledge and that you wish to submit your application. Full Name
Current Date

To submit your application click the button below.

PLEASE NOTE: If there are errors in your application, you will remain on this page, and there will be error messages above the incomplete entries. Please correct errors and click the button again.