Northwest Missouri State University
372 Administration Building
800 University Drive
Maryville, MO 64468
SUMMER EMPLOYMENT APPLICATION
Application must be completed and returned by Monday, March 6th, 2017
to the Upward Bound Office
Applying for: ☐Resident Assistant ☐Teaching Assistant ☐Enrichment Instructor
Date: Click here to enter a date.
Name: Click here to enter text. Local Address: Click here to enter text. Primary Phone: Click here to enter text.
Permanent Address: Click here to enter text.
E-mail: Click here to enter text.
Northwest Student ID#: Click here to enter text.
TRiO Participant: ☐Yes ☐No
If yes, what program(s) and dates of involvement: Click here to enter text.
Student Classification: ☐Fr. ☐So. ☐Jr. ☐Sr. ☐Graduate
Major(s): Click here to enter text.
Minor(s): Click here to enter text.
Current/Final College GPA: Click here to enter text.
Please include a résumé, current transcript, and three recommendation forms (provided on the UB website).
List the name of the three people you have asked to give references.
Name Relationship Telephone
1. Click here to enter text.
2. Click here to enter text.
3. Click here to enter text.
(It is your responsibility to see that their recommendations are submitted to Upward Bound by the deadline date.)
Please answer the following question:
1. What experiences have you had traveling with and/or supervising adolescents? (Limit word count to end at pg.1)
Click here to enter text.
Northwest Missouri State University
372 Administration Building
800 University Drive
Maryville, MO 64468
SUMMER EMPLOYMENT APPLICATION
Application must be completed and returned by Monday, March 6th, 2017
to the Upward Bound Office
Please answer the following questions:
2. What role(s) have you played as a team-member?
Click here to enter text.
3. Do you have any skills or interests that you feel would contribute to the program and you would feel comfortable sharing with others (e.g. PE, arts, crafts, guitar, dance, computers, photography, etc.)?
Click here to enter text.
4. Are you planning to enroll in any classes during the summer? ☐Yes ☐No
If yes, please indicate which session and the days/times of the classes? If yes, when will you study?
Click here to enter text.
5. Have you been a tutor or mentor before? ☐Yes ☐No
If yes, please list subjects and levels and the organization that conducted the training.
Click here to enter text.
6. Please mark the area(s) in which you feel you could tutor high school students in:
☐English ☐Science ☐Math ☐Social Science ☐Spanish
7. Do you currently hold a valid Driver’s License? ☐Yes ☐No
Have you ever driven a 15-passenger van? ☐Yes ☐No
Have you been convicted of any traffic violations in the past three years? ☐Yes ☐No
If yes, please explain:
Click here to enter text.
8. Upward Bound will be in session from May 31st – July 14th. Do you have any conflicts with these dates? ☐Yes ☐No
If yes, please provide the dates and reason:
Click here to enter text.
Northwest Missouri State University
372 Administration Building
800 University Drive
Maryville, MO 64468
SUMMER EMPLOYMENT APPLICATION
Application must be completed and returned by Monday, March 6th, 2017
to the Upward Bound Office
Complete this portion of the application, page three, if you are applying for an Enrichment Teacher position.
Please describe your class proposal(s) below:
Title of proposed class: Click here to enter text.
Description of class: Click here to enter text.
Have you ever taught this class? ☐Yes ☐No
If yes, where? Click here to enter text.
Contact person and phone number: Click here to enter text.
Title of proposed class: Click here to enter text.
Description of class: Click here to enter text.
Have you ever taught this class? ☐Yes ☐No
If yes, where? Click here to enter text.
Contact person and phone number: Click here to enter text.
Describe your experience or expertise in the area of the proposed class(es) you would like to teach:
Click here to enter text.
Enrichment classes are held on Monday, Tuesday, and Wednesday afternoons. These classes are incorporated into the Upward Bound program to provide participants with possible career, hobby and recreational interests. Enrichment Teachers will work June 5th – July 7th, 2017.
Do you have any conflicts with these dates? ☐Yes ☐No
If yes, please provide the date(s) and reason: Click here to enter text.
Northwest Missouri State University
372 Administration Building
800 University Drive
Maryville, MO 64468
SUMMER EMPLOYMENT APPLICATION
Application must be completed and returned by Monday, March 6th, 2017
to the Upward Bound Office
Briefly answer the following questions on a separate sheet and attach to your application.
1. What do you feel are your most important traits that will be a positive influence on Upward Bound students?
2. What work ethic principles do you have that will contribute to the Upward Bound staff?
3. Please share previous experience working with low-income, first generation students and/or your personal experience overcoming academic and economic obstacles, if any.
4. How would you motivate students to study and abide by Upward Bound rules and expectations?
Page | 1