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Graduate Assistant Application

Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or differently-abling condition.

Personal Information
Local Address
Permanent Address
Proof of citizenship status will be required upon employment.

Colleges and Universities Attended
Please include all colleges and universities attended, including Mount St. Mary's University. List the most recent first.
Institution 1
Institution 2

Work Experience
List last two employers (most recent first):
Recent Employer 1
Recent Employer 2

Authorization and Signature
I hereby authorize my former employers and individuals listed herein to release to Mount St. Mary's University, and any agent acting on its behalf, my records from any and all former employers, references, and any or all educational institutions, as well as information as to my character and ablility and verification of matters stated herein. I hereby certify that the information supplied in this application and other submitted application materials are complete and correct. I understand that any omission or misstatement herein can be grounds either for refusing to hire me or for terminating my employment if I have already been hired. Moreover, I hereby release Mount St. Mary's, and any agent acting on its behalf, from any and all liability of whatever nature by reason of requesting such information from any person.
Important Information Regarding Graduate Assistanships
By checking the box below, I am stating that I have read and agree to abide by the terms of this application. (see Important Information link)

Provost's Office • Bradley Hall, Room 219 • 16300 Old Emmitsburg Road • Emmitsburg, MD 21727 • (301) 447-5218 • (301) 447-5863 fax

16300 Old Emmitsburg Road | Emmitsburg, MD 21727
Map & Directions | | 301-447-6122
Frederick Campus | 5350 Spectrum Drive | Frederick, MD 21703
Map & Directions | | 301-682-8315