Application Form

Employment Application [attach resume]

MEMBER DETAILS
Last Name	First Name
Local Address Street Apt # City, State Zip		SSN:
Permanent Address Street Apt # City, State Zip Are you a U. S. Citizen or permanent resident? Yes No If No - state your citizenship Do you have authority to work in the U.S. under this appointment? Yes No If yes, please attach the necessary documents. If no, this appointment cannot proceed		Home Phone Cell Phone Date of Birth Male Female

Period of Employment

Available Start Date	Graduation Date
Hours : [10] / Week	Rate of Pay [$8.65] / Hour

Qualifications

Use this area to provide some details about your interests, skills and what projects you might like to work on.

URL of Resume file:

Supervisor name and position [Bettina Bair, TWiCE Director]

Supervisor's contact info [614-292-2565, bbair@cis.ohio-state.edu]

Condition of Employment

Initial six weeks will be served as a probationary member, doing research and skill development as described in Weekly Tasks. Permanent status is dependant on the completion and acceptance of a Project Plan.

DECLARATION by MEMBER

This offer of further appointment is made conditional upon and subject to approval and confirmation by TWiCE. management and the CIS department Human Resources officer.

This offer is made in accordance with the conditions of employment as provided by OSU regulations and guidelines.

I accept this offer of employment on the terms and conditions stated above and declare that the information I have provided is accurate. Notwithstanding any representation to the contrary, I agree that the University is not under any obligation express or implied to renew the contract or offer any employment after the expiry of the contract term.
I have disclosed all other employment/consultancy agreements that I currently hold.

I agree to these conditions of employment

I do not agree