Employment Application
Virginia Tech Services, Inc.
Please Print Clearly or Type and Use the Submit Button at the Top of Form
Position Applied For: ____________________________
Social Security Number: _______________________
(Optional, required if hired)
Rush Clerk
How Did You Learn About Us? CT ad ____ Dorm flyer ____ Store hiring banner ____ Bookstore website ____ Other ____
* If hired, what specific date are you available to begin work? ____________________________________________________________
_______________________________________________________________________________________________________
* Last Name
First Name
Middle Name
_______________________________________________________________________________________________________
* Local Address
City
State
Zip Code
________________________________________________ ______________________________________________________
* Cell Phone Number
E-Mail Address
* If you are under 16 years of age, can you provide required proof of your eligibility to work? Yes No N/A
Have you ever been employed with us before? Yes No
If Yes, give date ____________________
Have you been convicted of a felony within the last seven years? Yes No
(Conviction will not necessarily disqualify an applicant from
If Yes, please explain __________________________________________________________________________
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? Yes No
(Proof of citizenship or immigration status will be required upon employment.)
Original documents (not copies) that establish both identity and employment eligibility must be
presented
for employment purposes. Examples of acceptable documents include a U.S. Passport or Driver's
License
and Social Security card or Driver's License and Birth Certificate. A complete list of acceptable
I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all state