Federal Work-Study Application Form

• *First Name:
• *Last Name:
• *Student ID: (see your award offer)
•  
• *Address:
• *City:
• *State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
• *Zip:
•  
• *Date of Birth:
• *Phone Number:
• *E-mail:
• *Main Campus: Select your main campus Clinton Community College Muscatine Community College Scott Community College
• *Current Program of Study:
• *Term of Desired Start:
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• *Transportation: (Check all that apply)
  

  My own vehicle
  Public transportation

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• *Desired Location: (check all that apply for your campus location)    
  
  Clinton Community College
  

  Lincoln Blvd Campus
  Maquoketa Campus
  Bickelhaupt Arboretum
  America Reads/Counts Tutoring (at a local elementary school)
  Community Service (at a local non-profit agency)

  
  
  
  Muscatine Community College
  

  Colorado St Campus
  Nahant Marsh
  America Reads/Counts Tutoring (at a local elementary school)
  Community Service (at a local non-profit agency)

  
  
  
  Scott Community College
  

  Belmont Campus
  District Office/Urban Campus
  Blong Technology Center
  West Davenport Center
  Nahant Marsh
  America Reads/Counts Tutoring (at a local elementary school)
  Community Service (at a local non-profit agency)

  
  
  
•  
• *Skills and Abilities: (Check all that apply)
  

  Arts and Crafts
  Cafe
  Clerical (Such as scanning, filing, data entry, telephones, and organizational skills)
  Computer Skills
  Environmental Preservation
  Food Pantry
  Food Preparation and Serving
  Landscaping
  Library
  Maintenance
  Microsoft Office (Word, Excel, Outlook, PowerPoint)
  Tutoring
  Working with Children (elementary or teen)
  Other

      *Specify Other:
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• *Knowledge Areas: (Check all that apply)
  

  Math
  Reading
  Science
  Technology
  Writing
  Other

      *Specify Other:
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Next Steps

To view a list of potential work-study positions, visit eicc.edu/workstudy. Once you have identified positions that you are interested in, it is your responsibility to email the contact person to request an interview. Some positions may have already been filled. Employment is not guaranteed.

If you are hired for a work-study position, you must make an appointment with the Financial Aid Office to complete pre-employment paperwork. You will not be able to start working until all required pre-employment paperwork is complete and submitted to the Financial Aid Office.

I hereby certify that all my statements are true and authorize investigation of all statements contained in this application.

• *Student Signature :
• *Date
•  

America Reads/Counts Program

Students who meet the eligibility requirements for the Federal Work-Study program may be able to earn their work-study wages through the America Reads/Counts program.

How the program works:

- College students tutor young elementary school students in reading and/or math during school

- Tutors go to elementary schools to work one on one with the children

- Tutors receive training and support to make the tutoring experience both rewarding and effective

The college student tutors will work with the young students to provide extra instructional help in subjects where improvement is needed. The tutor's role is often not only to help the students raise their grades, but also to improve the youth's attitude and increase their self-confidence and pride in achievement. An important focus of this program may be to help students recognize the importance of school, and to understand how to be more successful in their classes.

College students who wish to become a part of the program must complete an application form, complete a background screening, and interview with the classroom teacher or other school personnel. There will be a formal training program conducted prior to beginning tutoring. Students will keep a log of their hours and activities, and will work under the direct supervision of teachers in various local elementary schools.

Students from any area of concentration may apply to become part of the program. Education and/or Human Services majors may especially want to consider applying. Benefits for tutors include gaining valuable skills, building their resume, meeting new people, and connecting with their communities. Students who are accepted for the program will be paid the standard $12.50 per hour work-study wage.

For more information about the program, contact your campus Financial Aid Office.

Community Service

A limited number of positions are available in the community at not-for-profit agencies. An interview with the agency will be conducted before a student is hired. Students in community service positions will work under the direct supervision of an employee of the not-for-profit agency. Work study students are paid the standard $12.50 per hour work-study wage.

For more information about the program, contact your campus Financial Aid Office.

It is the policy of Eastern Iowa Community College District not to discriminate in its programs, activities, or employment on the basis of race, color, national origin, sex, disability, age, sexual orientation, gender identity, creed, religion, and actual or potential family, parental or marital status, as required by the Iowa Code §§216.6 and 216.9, Titles VI and VII of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000d and 2000e), the Equal Pay Act of 1973 (29 U.S.C. § 206, et seq.), Title IX (Educational Amendments, 20 U.S.C. §§ 1681-1688), Section 504 (Rehabilitation Act of 1973, 29 U.S.C. § 794), and Title II of the Americans with Disabilities Act (42 U.S.C. § 12101, et seq.).

If you have questions or complaints related to compliance with this policy, please contact EICC’s Equal Employment Opportunity Officer/Equity Coordinator, Eastern Iowa Community College District, 101 West Third Street, Davenport, Iowa 52801, 563-336-5222, equity@eicc.edu or the Office for Civil Rights, U.S. Department of Education, Cesar E. Chavez Memorial Building, 1244 Speer Boulevard, Suite 310, Denver, CO 80204-3582, Telephone: 303-844-5695. FAX: 303-844-4303; TDD: 800-877-8339 or Email: OCR.Denver@ed.gov.