Home Address:
Home Phone:
Class Year: 2007 2008 2009
Check if currently abroad
E-Mial Address: (required)
Social Security Number:
Campus Box Number: Campus Extension:
Student ID: Major:
Will you need on campus housing?Yes No
If you will need on campus housing for the summer you need to contact Jacques Moore in the Office of Special Programs to apply for housing. (jrmoore@colby.edu or x4732) Date Available to Begin Work (First day of summer employment program is 5/30/06)
Last Date Available for Work (Last day of summer employment program is 8/18/06)
Typing: WPM Languages: Lifeguard:SeniorW.S.I. Childcare: Ages Art Skills Projection Equipment Driver's License
Please use Colby references when possible.
Reference 1
Department/Company Position Name Phone # Dates of Employment
Reference 2
Reference 3
Why do you want to work at Colby this summer?
Please list the positions you are interested in: