Qualtrics Survey | Qualtrics Experience Management

Full First Name

Full Middle Name

Last Name

Preferred Name

Gender

Male
Female
Choose not to say

Email- This will be the main form of communication moving forward

Cell Phone Number

Full Adress

I am an orphan or surviving spouse (who has not remarried) of a veteran killed on active duty who had served in the military for not less than 90 consecutive days during national emergency in accordance with federal law, and I am competent. ?

Yes
No

I have served in the military for not less than 90 consecutive days during a national emergency declared in accordance with federal law and was discharged with other than dishonorable discharge or discharged for an established service connected disability, or I have served in a campaign or expedition for which a campaign badge, a service medal, or an expeditionary medal was awarded, and I am competent?

Yes
No

Name of last High School attended

City, Sate of High School

Did you graduate?

Yes
No

Are you currently enrolled in college? If so, please name the institution, your major, and academic classification.

Please list all licenses and certifications.

Have you ever been convicted of a violation of any local, state or federal law, other than minor traffic violations? (This includes a plea of guilty or no contest.)

Yes
No

If yes, please list all convictions and dates below.

In compliance with Texas A&M University System policy on nepotism, answer the following. Are you related to any current Texas A&M University System employee, official, or regent?

Yes
No

If yes, where does the relative work?

Select all the following categories in which you identify:

White (not of Hispanic origin) All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East
Black (not of Hispanic origin) All persons having origins in any of the black racial groups of Africa
Hispanic. All persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture/origin, regardless of race
Asian or Pacific Islander. All persons having origins in any of the original peoples of the Far East, Indian Subcontinent, Southeast Asia, or the Pacific Islands
American Indian or Alaskan Native. All persons having origins in any of the original peoples of North America

INDIVIDUAL WITH A DISABILITY. I have chosen to be identified as an individual with a disability because I have a record of, or I am regarded as having a physical or mental impairment which substantially limits one or more of the major life activities.

Yes
No

VETERAN. I served in the United States Army, Navy, Marine Corps, Air Force, or Coast Guard, in a reserve unit of one of these military components, or in the National or Air National Guard of the United States, and was discharged or released under conditions other than dishonorable.

Yes
No

* DISABLED VETERAN. I have a disability that entitles me to Veterans' Administration disability compensation rated at 30 percent or more; or was discharged or released from active military duty because of a disability incurred or aggravated in the line of duty.

Yes
No

List any club, organization, or other areas of college life that you are involved in.

Applicants must be 18 years or older before June 1 of the application year. Applicants must be able to pass a criminal background check. CPR/First Aid Certification and a valid driver's license are required for some employees.

JOB FUNCTIONS:

1. Able to interact with and supervise children in a rustic environment during a 24 hour, 7 day a week period.

2. Able to provide a wholesome environment in which campers experience success.

3. Able to maintain a positive example in personal life and daily living situations which demonstrates a loving and positive attitude towards campers and others.

4. Able to carry out duties in the West Central climate (generally hot and dry).

5. Possess the stamina to implement the camp program and daily activities over an extended period of time.

6. Able to traverse approximately five miles per day over rough, natural terrain while supervising campers.

Can you perform the essential functions of the job for which you have applied, with or without reasonable accommodations?

Yes
No

I certify the statements made by me in this application are true, complete, and correct tot he best of my knowledge and belief and are made in good faith. I understand that any false statement made herein will void this application and any actions based upon it. I agree to revise this applications should any of the information change. I authorize Texas A&M University System or any of its components to make reference checks relating to my employment and I also authorize all prior employers to provide full details concerning my past employment. I understand that this application and all attachments are the property of the TAMU system. I understand that in the event I am employed, the first six months of my employment are probationary. I also understand that if I am eligible for overtime under provisions of the Fair Labor Standards Act, all hours I work in excess of 40 in a work week will be recorded in a compensatory time bank, at time and a half, unless management elects to pay me at time and a half. Furthermore, that I can take compensatory time off so long as my doing so would not unduly disrupt the activities of my department and my supervisor approves such absence. Unused overtime compensatory time will b paid upon termination of employment. I understand that if I am male, I am required to sign a Certification of Registration of Status for the Selective Service as a requirement for employment. I further understand that if I am a male age 18-25, I must show proof of registration with Selective Service at the time of hire. I understand that any offer of employment is contingent upon my completing the Immigration and Naturalization Service Employment Eligibility Verification (Form I-9) and providing documents to verify my identity and employment eligibility as required by law.

Please typer your name and date.