Application for Part-Time Employment

Personal Information

What position are you interested in? *

Institution of Higher Education (Are you a student now?) *

MSU

OtherOther

None

Note: If you are currently a faculty/staff member at MSU or are a non-student, please select "None."

First Name *

Do you have a middle name? *

Yes

No

Middle Name *

Last Name *

Suffix

Date of Birth *

Telephone

Format (xxx) xxx-xxxx

Drivers License Number or State ID Number

Issuing State

MSU Student A PID Number

MSU Employee Z PID Number

Email

Are you a citizen of the United States? *

Yes

No

Are you authorized to work in the United States? *

Yes

No

Address Information

Address Type *

Local Address

Permanent Address

OtherOther

Address *

Address

Street Address 1

Street Address 2

City

State/Province

Zip/Postal

Add Another Address Remove Address

Education Information

Student Information

Declared Major *

Expected Graduation Semester *

Fall

Spring

Summer

Expected Graduation Year *

Background Information

Have you ever been arrested for a misdemeanor offense (e.g. open alcohol in vehicle, assault)? If yes, please provide dates, jurisdiction, location, and details of the case. *

No

YesYes

Have you ever been arrested for a felony offense? If yes, please provide dates, jurisdiction, location, and details of the case. *

No

YesYes

Have you ever received a civil infraction unrelated to a vehicle offense (e.g. noise violation, ordinance violation)? If yes, please provide dates, jurisdiction, location, and details of the case. *

No

YesYes

Has your driver's license ever been suspended or revoked? If yes, provide dates, jurisdiction, location, and details of the situation. *

No

YesYes

Have you ever received a moving violation (e.g. speeding, failure to signal)? If yes, specify the total number of violations received. *

No

YesYes

Have you ever accumulated more than 6 unpaid parking violations issued by MSU or in the City of East Lansing? If yes, please provide jurisdiction, location, and reason for being unpaid. *

No

YesYes

Do you currently have any unpaid parking violations issued by MSU or the City of East Lansing? If yes, please provide details about the situation. *

No

YesYes

Have you ever had contact with a police officer for any official police matter? If yes, please provide details about that contact. *

No

YesYes

Personal Reference Information

Please provide at least 3 personal references and at least ONE must be a non-family member. You may add more by clicking the "add" button.

Name (Last, First) *

Telephone *

Relationship *

Years Known

Add Remove

Have you ever held a job or been employed?

Yes

No

Have you ever worked at MSU?

Yes (then list this job in the Employer Reference Information Section)

No

Do you currently work at MSU?

Yes (then list this job in the Employer Reference Information Section)

No

Employer Reference Information

Please provide employer references for current or former jobs. You may add more by clicking the "add" button.

Name (Last, First)

Position Title

Telephone

Company Name and Address

Dates of Employment

Reason for Leaving (Please be detailed)

Add Remove

Attestation and Acknowledgement

I acknowledge by submitting this form that I have read and understood the information provided outlining the job qualifications, duties, working conditions, and hiring process. I understand that my tendering, or the Michigan State University Police Department accepting this application does not constitute employment or an offer of employment. I also understand that any false or misleading information provided by myself on this application or in connection with this application for employment may result in the rejection of this application; or if employed, may result in the termination of employment.

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