Become An STF

I am a resident of South Dakota

YesNo

Hometown

First Name

Last Name

Address

City

State

ZIP Code

Home Phone

Cell Phone

Next semester, I will be a

FreshmanSophomoreJuniorSenior

How did you hear about the Student Technology Fellows Program?

Work Experience #1

(Two Work References Required)

Position Title

Employer

Start Date

End Date

Description of Duties

Work Experience #2

Position Title

Employer

Start Date

End Date

Description of Duties

Work Experience #3

Position Title

Employer

Start Date

End Date

Description of Duties

In the past 3 years, what job responsibilities have given you the most personal satisfaction and why?

Academic Information

Overall GPA

Please provide courses, instructor name, and your course grade that is related to computers.

Will you be taking at least 30 credit hours this coming school year?

YesNo

Please rate your level of skill

Microsoft Word

Microsoft Excel

Microsoft Access

Microsoft PowerPoint

Camtasia Studio

Adobe Captivate

Adobe Illustrator

Adobe Photoshop

Flash

Adobe Dreamweaver

Other Applications

Technology Experience and Knowledge

How have you gained knowledge and experience using computer and communication technologies?

Reference #1

(Two References Required)

First Name

Last Name

Title

Phone

Reference #2

First Name

Last Name

Title

Phone

Reference #3

First Name

Last Name

Title

Phone

By entering your name below, you certify that all of the information on this form is true and complete to the best of your knowledge.

Electronic Signature

Date

Contact Information