Roanoke College

Name:
Date:
Box:
Summer Address:
Local Phone:
E-mail Address:
Class for 2012/2013 school year:	Freshman Sophomore Junior Senior
Will You:	Live on Campus (2013-2014) Commute (2013-2014)
Anticipated Major:
Anticipated Minor:
Do you qualify for work study?	YES NO NOT SURE
Approximate number of hours per week you can work:
Are you available for potential summer employment?	YES NO
Overall GPA:
Have you ever been found responsible for an Academic Integrity Violation?	YES NO
Have you ever been found responsible for a Student Conduct Violation?	YES NO
Are you or do you plan to be an RA or in the Maroon Corps?	YES NO
Please list any computer related courses you have taken at Roanoke College:
Have you ever held an on-campus job before?	YES NO
If yes, please list what department the job was in and who your supervisor was.
Please list a faculty or staff member of Roanoke College from whom we could obtain a reference.
List any experience you have with:
Software:
Operating Systems::
Hardware:
Network:
Telephone/Helpdesk
Programming Languages: