E M P L OY M E N T A P P L I CAT I O N

Join Our Team!

As a member of the Dixie State Dining Services family, you can expect several things from us:• Flexible work schedules (YES - we WILL work around your class schedule!)• Work locations close to your classes and student housing• A fair and respectful work place• A chance to be part of our Award Winning Dining Services Team that can make a

difference on the Dixie State campus!• Unlimited opportunities to grow both in your personal and professional life• Opportunity to learn new culinary and life skills

Do you have what we are looking for? Our ideal team members are:• Friendly! They give enthusiastic service to every customer - every time.• Dependable! Arrive on time for all shifts and provide their own transportation.• A team player! Teamwork is key to the successful operation of all our campus locations.• Work with a sense of urgency! Our customers want scrumptious food - served

fresh and fast.• Honest!• Follow instructions!

At Dixie State Dining Services, we look for team members who are commited to providing outstanding service while delivering quality food to our customers!

All Dining Services employees are required to obtain a State of Utah Food Handler’s Permit, prior to their first shift.

Sounds like a place you want to work? If so, please complete the application and return it to the Dining Services Office, located on the first floor of the Gardner Center, on the Dixie State University campus!

When a position becomes available, and if your class schedule fits our needs, we will call you for an interview. All applications are kept on file for 6 months.

If you are attending Dixie State University, please provide a current copy of your class schedule.

Follow these instructions to print your DSU Class Schedule to turn in with your application:

• Go to the “myDixie” webpage and log into your student account.• Click on “Student” at the top and then click on “Registration”.• Select “Student Schedule by Day and Time”.• Please print class schedule for the semester that you are applying for (Fall or Spring).

DIXIE STATE UNIVERSITYDINING SERVICES

APPLICATION FOR PART TIME STUDENT EMPLOYMENTDixie State University is an Affirmative Action/Equal Opportunity/Equal Access Employer

Dining ServicesDixie State UniversityGardner Center225 South University AveSt. George, UT 84770

RETURN TO: TEL (435) 652-7676FAX (435) 656-4023

TYPE OR PRINT CLEARLY IN INK.COMPLETE EACH ITEM FULLY. Do not submit a resume in lieu of an application

Position(s) desired:

Name:

Local address:

Permanent address:

Date:

Student ID #:

Social Security #:

Home Phone:

Cell Phone:

Email:

Degrees earned (list highest first):

Degree:

Name of the institution:

Location of the institution:

Degree:

Name of the institution:

Location of the institution:

Street

State

State

State

City

City

City

City

Zip

Zip

Street

State

Have you ever been employed by Dixie State University before? Yes No

Check the highest year completed:

High School:

College/University:

Major emphasis:

Major emphasis:

EDUCATION

If yes, complete the following:

List any relatives who have worked at Dixie State University and their relationship to you:

Relative 1:

Relative 2:

Relative 3:

Relation:

Relation:

Relation:

Position:

Department: Dates: To:

14 15 1613

8 9 10 11 12 GED

Supervisor:Phone:Dates:Hours worked per week:

Supervisor:Phone:Dates:Hours worked per week:

Supervisor:Phone:Dates:Hours worked per week:

To:

To:

To:

Firm Name:

Address:Job title:

Months employed:Reasons for leaving:Duties:

Firm Name:

Address:Job title:

Months employed:Reasons for leaving:Duties:

Firm Name:

Address:Job title:

Months employed:Reasons for leaving:Duties:

Do you currently have a ServeSafe Certificate?

Do you currently have a Food Handler’s Permit for the State of Utah (Southwest Region)?

Are you able to obtain a Food Handler’s Permit for the State of Utah (Southwest Region)?

Full Time

Full Time

Full Time

Part Time

Part Time

Part Time

Internship/Volunteer

Internship/Volunteer

Internship/Volunteer

Experience:Beginning with your present or most recent experience, list three (3) or more previous employers. Are you willing to have your present employer contacted regarding your qualifications? Yes No

YesYesYes

NoNoNo

When will you be attending Dixie State University?

In order for Dixie State University to protect its populace and property, applicants are required to answer the following question: Have you ever been convicted of a felony?

I certify that the statements made by me in this application are true, complete and correct to the best of my knowledge. I understand that false information made herein will result in disqualification or dismissal, if hired. I authorize Dixie State University to investigate all statements made and implied in this application. I also grant Dixie State University permission to contact references and previous employers, unless noted above. I understand that I may omit any information requested which I feel is illegally discriminatory in nature.

If yes, you are required to complete an additional form, available at the Human Resources Office.

Are you currently authorized to work in the United States (citizenship or appropriate visa)?

Signature Date

Yes No

Yes No

fall spring summer not attending