College Peer Advisor

Job Application

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School Site(s) of Interest (Mark all that apply):
Arvin High Frazier Mtn. Mira Monte Taft High	Cuyama High Kern Valley High Rosamond High Tehachapi High	Foothill High Maricopa High Shafter High Trona High
Date:	mm/dd/yyyy
CSUB ID#:
Name: First		Middle	Last
Mailing Address:			Apt#:
City:		State:	Zip:
Home Phone:	e.g. 661-555-1234	Cell Phone:
E-mail Address:
Personal Information
Are you bilingual?
Yes     No
If yes, state language(s) spoken:
Are you over the age of 18?
Yes     No
Are you legally eligible to work in the US?
Yes     No
Have you been previously employed with CSU Bakersfield?
Yes     No
If you have ever worked under a different name, please state name:
Each prospective employee must undergo a background clearance through the Department of Justice prior to employment. Fingerprinting clearance is pursuant to Education Code 45125(a) as amended by AB 1610, Stat 1997.
Have you ever been convicted of a misdemeanor?
Yes     No
Have you ever been convicted of a felony?
Yes     No
Have you ever entered a plea of No Contest or Guilty to a Misdemeanor?
Yes     No
Have you ever entered a plea of No Contest or Guilty to a Felony?
Yes     No
A conviction will not necessarily disqualify you from employment.
Education
Please indicate education of training that you believe qualifies you for the position you are seeking.
High School:		City/State:
Diploma:	Yes     No
G.E.D.:	Yes     No
High School Proficiency Exam:	Yes     No
College and/or Vocational School		City/State:
Major:		Degrees Earned:
Alternate Major:		Minor:
Current School:		Expected Graduation:
Do you receive Financial Aid?	Yes     No
Current Status:	Full-Time     Part-Time
Year in College:	-select- Freshman Sophomore Junior Senior Graduate Credential Program
Employment History
Begin with current or most recent employer. Do not exclude any employment. Include applicable temporary employment. Applicants that do not clearly meet the minimum required experience will be rejected.
Job 1
Company Name:
Employment Dates:	From:	To:
Position:		Supervisor's Name:
Address:		Phone:	e.g. 661-555-1234
Describe your duties:
Reasons for leaving:
Job 2
Company Name:
Employment Dates:	From:	To:
Position:		Supervisor's Name:
Address:		Phone:	e.g. 661-555-1234
Describe your duties:
Reasons for leaving:
Short Answer
Please provide a brief response to the following questions. Use additional page(s) to complete your answers. Limit responses to no more than two pages in total.
1. Do you have any previous tutoring, advising, or mentoring experience with students? Are there any particular academic subjects that you feel more comfortable with than others?
2. Keeping the job functions in mind, what high school and postsecondary experiences have you had that you feel would be beneficial to share with high school students?
3. Most of the schools we serve are low-income, under-performing, or have traditionally under-served student populations. Do you have experience working with a diverse student population? In what ways? If not, do you feel you could effectively work in a diverse environment? Explain.
4. How might you establish a rapport with students who do not want to go to college?
5. What are your career goals? How do you feel that working with Cal-SOAP will help you reach these goals?
Availability
Please list your hours of availability for the current quarter/semester:
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
Professional References
Please list two persons, who are not related to you, who can provide professional references.
Ref 1
Name:		Phone: e.g. 661-555-1234
Address:
Relationship:		Years Known:
Ref 2
Name:		Phone: e.g. 661-555-1234
Address:
Relationship:		Years Known:
Please provide any other information that you feel will help us in considering your application.
I hereby certify that all statements made in this application are true. I authorize the Office of Human Resources, California State University, Bakersfield to investigate my references, work record, education, and other matters related to my suitability for employment. I also authorize the references and my prior employers to disclose to the Office of Human Resources, California State University, Bakersfield any and all letters, reports, and other information related to my professional and personal background, without giving me prior notice to such disclosure. I agree and understand that any misstatements of material facts herein will cause (a) rejection of my application and (b) forfeiture on my part to employment with the So. San Joaquin Valley Cal-SOAP Consortium (Cal-SOAP). I further agree to be fingerprinted, to submit to a complete medical examination, to provide my most current Financial Aid Award Letter or other document that displays financial need, and upon employment, to furnish my current unofficial college transcript, quarterly verification of GPA/schedule of classes and such proof of age and citizenship as may be directed. I agree       I disagree
You will be required to submit a Resume, Unofficial Transcript and Financial Aid Award Letter prior to having an interview. If possible please email all documents as an attachment to mbaltazar@csub.edu or submit directly to the Cal-SOAP office.
Imelda Simos-Valdez, Cal-SOAP Director California Student Opportunity & Access Program (Cal-SOAP) California State University, Bakersfield 9001 Stockdale Highway, 46 MOD Bakersfield, California 93311-1022 (661) 654-6157 (661) 654-6521 (fax) isimos_valdez@csub.edu
To update your application form after online submission, please contact Maria Baltazar, Assistant Director, at (661) 654-6168 or email at mbaltazar@csub.edu
	Submit    Clear

Southern San Joaquin Valley Cal-SOAP
Modular East II, Room 320-46 MOD
California State University Bakersfield
9001 Stockdale Highway
Bakersfield, California 93311