Applicants Name	*
Telephone Number	*
Email Address	*
Dorm and Room # or Home Address	*

Major	*
Classification	Freshman Sophomore Junior Senior
Areas of Interest	PC Repair Web Development Programming Help Desk Data Entry Telecommunications Networking Other:
Current Skills (Please rate yourself on a scale of 1 to 5 with 1 being "some" and 5 being "excellent". Leave blank if no experience.)	1 2 3 4 5 Data Entry 1 2 3 4 5 PC Repair 1 2 3 4 5 Help Desk 1 2 3 4 5 UNIX/LINUX 1 2 3 4 5 Microsoft Office 1 2 3 4 5 MS Office Macros & VBA 1 2 3 4 5 Visual Basic 1 2 3 4 5 Other: 1 2 3 4 5 Windows 2000/XP 1 2 3 4 5 Web Development 1 2 3 4 5 HTML 1 2 3 4 5 ASP 1 2 3 4 5 Adobe Photoshop 1 2 3 4 5 Adobe Illustrator 1 2 3 4 5 Networks
Work Experience Dates Company Description of Duties From To