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Proctor Space
Application
Personal Identification: Please enter valid data in each field.
Last Name:
*
First Name:
*
Middle Initial:
*
NU ID#:
*
Class Status:
College:
The position you are applying for:
Have you worked as a proctor for the College of Computer Science before:
No
Yes
List any related experience:
Will you be available as an "Emergency Proctor":

An "Emergency Proctor" is one who has some free-time and is available on short notice. Essentially, an "Emergency Proctor" is designed to fill in shifts that were discarded by less responsible proctors.

No
Yes

Home/Permanent Address: Please fill in your address. You must at least have a phone number to be reached at in case of emergency. If you're living at home, then simply duplicate the Permanent address from above.
Street:
*
City:
*
State/Province:
*
Country:
*
Zip Code:
*
Telephone:
- - *
School/Local Address: Please fill in your address. You must at least have a phone number to be reached at in case of emergency. If you're living at home, then simply duplicate the Permanent address from above.
Street:
City:
State:
Zip Code:
Telephone:
- - *
Email: Please list and label any email accounts you wish to share with us. You must at least have one at the College of Computer Science.
Username@CCS:
*
Username@LYNX:
Username@COE:
Username@ECE:
Username:
@

Are you registered with
Work/Study Program: 		If you do have workstudy funds, then you must complete the application for the workstudy department before filling out our application. You may only hold one workstudy job per semester so if you are hired based on the information given, you will be expected to use your workstudy funds here. If you run out of workstudy funds then you will be allowed to continue working for us at a part time wage depending on your grade level.
No - Then you are considered a "part-time" employee.
Yes - Then you are considered a "work-study" employee. Your award (dollars/quarter)

Citizenship: Description here.
U.S. Resident
International Student with an F-1 Visa
International Student with a J-1 Visa
Other. Visa type:

Work Schedule: Select any/all shifts that you are available to work:  Please highlight all the shifts you can work.  The more availability you have, the more likely you are to get hired.  By selecting all the shifts, it won't mean we will schedule you for all of them.  We will only schedule you for amount of hours you request in the following section.
TIME DAY
  Sun Mon Tue Wed Thu Fri Sat
8:00am - 9:45am
9:45am - 11:35am
11:35am - 1:20pm
1:20pm - 3:15pm
3:15pm - 5:05pm
5:05pm - 7:00pm
7:00pm - 9:00pm
9:00pm - 11:00pm
Hours per week desired: Please refer to the table below for reference. Please make sure you do not surpass the maximum number of hours per week. If at any point in time you work more hours than legally allowable, you will not be paid for those additional hours. Tracking your hours is YOUR responsibility.
Hours per week desired:    (The maximum amount of hours you want to work) 
                  Part-Time		           Work-study
 US Residents	        40 per week     US Residents	        20 per week
 International ( F-1 )	20 per week     International ( F-1 )	20 per week
 International ( F-2 )	 0 per week     International ( F-2 )	 0 per week
 International ( J-1 )	 0 per week     International ( J-1 )	 0 per week
 International ( J-2 )	 0 per week     International ( J-2 )	 0 per week
I-9 Verificaion: We are prohibited by Federal Law to pay anyone who has not completed the I-9 process. Anyone needing to complete the I-9 Verification process must bring the following documents to room 202 West Village H as soon as possible.

Note: You will not be paid until this process has been completed!

Citizenship
U.S. Citizen International Students with Visas International/Permanent Residents
Valid U.S. Passport Valid Passport Resident Registration Card
(Green Card)
Valid Driver's License with Social Security Card
Valid Driver's License with Birth Certificate
I-9 Verification completed and on file at:
Date Filed: (You do not need to fill out an I-9 form unless you are hired)
Are you currently a Graduate Assistant?
No
Yes
Are you currently a Teaching Assistant?
No
Yes
Are you currently a Tutor?
No
Yes
Are you enrolled in classes for the quarter you are applying for?
No
Yes
Are you working elsewhere on campus during the quarter you are applying for?
No
Yes
If so, list where and when:

I attest that the above information is complete and accurate; by clicking below I indicate that I have read this form in its entirety, completed it to the best of my ability, and understand that inaccurate information provided by myself are grounds for my dismissal.
I Understand and Agree
Please enter Today's Date (DD/MM/YYYY)
search Last Modified: $Date: 1999/09/10 13:29:25 $