STUDENT INFORMATION
*First Name
*Last Name
*UHD ID
Look Up UHD-ID?
*DOB
Month:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day:
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year:
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
CONTACT INFORMATION
Home Phone
Alternate Phone
*Email:
*Address:
*City:
*State:
*Zip:
CURRENT EMPLOYMENT
Are you employed?
Yes
No
If Yes,
Part-Time
Full-Time
Are you available to work June through August and November through January?
Yes
No
SCHOOL INFORMATION
Major:
Classification:
Freshman
Sophomore
Junior
Senior
Graduate
Overall/Current GPA:
Intended Semester of Graduation:
How were you admitted into UHD?
Freshman
Transfer
Graduate
List the names of any other colleges and/universities attended:
List your current class schedule:
WORK / ORGANIZATION(S) EXPERIENCE
Please list your work and organization experience and/or email a copy of your resume to orientation@uhd.edu
SUPPLEMENTAL INFORMATION
Why are you interested in becoming an orientation leader? Please describe what you believe to be key roles of an orientation leader and what you can bring to the team:
If you could give advice to a prospective student about the university, what would it be and why:
List and discuss three personal strengths:
What is the one thing you are most proud of at UHD:
REFERENCES
You are required to submit two references as part of the application process. The references' names, professional titles and phone numbers should be written below. your references may be contacted as part of your application and interview process.
Name
Title
Phone
Name
Title
Phone
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