* Incomplete applications will not be considered. Please fill out all of the fields listed (enter NA where Not Applicable).

Name

Last Name
First Name
Middle Name

Address

No. Street
City
State
Zip

Contact Information

Telephone Number
Telephone Number
Email Address

Eligibility

Are you 18 years of age or older ?

Education

Type
Name/Location
Course of Study
#Years Completed
Degree/Diploma
High school
College
College
College
Technical/Other

Employment History

Employer 1
Company Name
Company Address
Position within Company
Start/End Date
Reason for Leaving
Description of Duties
Employer 2
Company Name
Company Address
Position within Company
Start/End Date
Reason for Leaving
Description of Duties
Employer 3
Company Name
Company Address
Position within Company
Start/End Date
Reason for Leaving
Description of Duties

Professional Reference

Name
Organization
Years Known
Telephone Number
 

Employment

How did you hear about the position you are applying for ?
What is your typing speed (please list words per minute)?
How would you rate your familiarity with computers?
No Familiarity Little Familiarity
Average Familiarity
Above Average Familiarity

Have you ever worked on the phone before?
(If yes, please describe)

Do you have any experience with conducting research?
(Please describe)

Please list any additional information that relates to your
ability to perform the job for which you have applied.

Employment

We would like to get a sense of your general availability. Our shifts are 4 hours long and you can work up to two shifts per day. Our standard operating hours are Monday Through Friday 1pm - 9pm, Saturday 10am - 6pm, and Sunday 12pm - 8pm. Please indicate below what shifts you are generally available for:

  Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1st shift
2st shift

Affirmative Action Statement


Portland State University is an Affirmative Action, Equal Opportunity
Institution and,in keeping with the President's diversity initiative, welcomes
applications from diverse candidates and candidates who support diversity.


Submit Application


CERTIFICATION AND SIGNATURE

I understand that any oral or written statement that is false, fraudulent or misleading
that is contained in this application or attached materials, or made in the course of any
related employment process, whether made by me or by others at my request, will result
in rejection of my application, denial of employment, or dismissal from Portland State University
if discovered after employment, and/or prosecution for a crime. I further understand that I
must prove that I am authorized to work in the United States if I am hired. I authorize
Portland State University to verify the information provided on this application.

By submitting this application you accept the above statement.

 
Address: 1600 SW 4th Ave,
Suite 900, Portland, OR 97201
Voice:503-725-9530
Toll-Free:800-530-5875
Fax: 503-725-4180