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Student Application Form

Full Name Date:
School Address


Phone: 		Home Address:


Phone:
Year:  
Major: 		Are you available during:
Summer? Yes No  Breaks? Yes No

Please place a checkmark beside sales department/area that interests you.
 Cashier/Office Clothing Computer General Book
Stockroom Supply Textbooks  

Describe the type of work experience that you have 

Why would you like to work at The Co-op Store?

References:
Name:
Address:


Phone: 		Name:
Address:


Phone:
Please type class schedule from 8:00am-6:00pm
(i.e.    Monday 8:00am-8:45am Engl 311)


Email Address:


(Please only hit submit once)

Correspondence regarding this site should be sent to its maintainer, Hazel Hull, <Email>. 
Please see IUP's statement regarding pages that do not officially represent the university.