OCRM Student Application

Please use the fields below to submit your application for employment to OCRM.

Applicant Information

Type of Appliciation

First Name

Legal Name

Last Name

Legal Name

MSU ID#

Current Address

Phone Number

Please use xxx-xxx-xxxx

E-mail

Are you a Mississippi resident?

Available Start Date

mm/dd/yyyy

Educational Information

MSU Academic Department

Most Recent GPA

Major Field/Concentration

Expected Graduation Date

Computer/Software Experience

Please check the boxes that correspond with a software/program you have experience with.

References

Please provide the name, relationship to you, and phone number of two (2) professional references.

First and Last Name

Relationship

Phone Number

Please use xxx-xxx-xxxx

First and Last Name

Relationship

Phone Number

Please use xxx-xxx-xxxx

Attach Résumé

Drop your files here

Certification of Submission Veracity

I certify that the above information is true to the best of my knowledge and belief. Furthermore, I understand that I subject myself to disciplinary action (including, but not limited to, termination of employment) in the event that the above information is found to be falsified.

Data Authorization

I authorize that all information provided on this form, including any and all personal, financial and academic data may be shared with MSU. This data may be securely retained indefinitely. To learn more about privacy at MSU, please see the MSU Privacy Statement.

Send me a copy of my responses

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