Workstudy Application

Student Name(Required)

First Last

Holmes ID Number(Required)

(ex. H00001101)

Address(Required)

Street Address City State ZIP Code

Cell Phone(Required)

Holmes Email(Required)

Enter Email Confirm Email

(ex. yourusername@student.holmescc.edu)

Which Campus do you Plan to Attend?(Required)

School year applying for?(Required)

What semester are you applying for?(Required)

Faculty Name(Required)

Please indicate below the name and location of the faculty or staff member you have been approved to work for. You must have their approval prior to completing the application.

Faculty Member's Location(Required)

EQUAL ACCESS/EQUAL OPPORTUNITY

Holmes Community College does not unlawfully discriminate on the basis of race, color, gender, sex, pregnancy, sexual orientation, gender identity or expression, religion, national origin, citizenship, age, disability, veteran status, or genetic information. Employees, students, applicants for admission or employment, or other participants in Holmes Community College programs or activities who believe they have been discriminated against are entitled to seek relief through the Compliance Officer (662) 472-9429. Written inquiries may be e-mailed to: compliance@holmescc.edu or sent to: Compliance Office, P.O. Box 369, Goodman, MS 39079.

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Workstudy Application

EQUAL ACCESS/EQUAL OPPORTUNITY

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