Workstudy Application Student Name(Required) First Last Â鶹´«Ã½ ID Number(Required)(ex. H00001101)Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone(Required)Â鶹´«Ã½ Email(Required) Enter Email Confirm Email (ex. yourusername@student.holmescc.edu)Which Campus do you Plan to Attend?(Required)Please select a campusGoodmanGrenadaKosciuskoRidgelandYazoo CitySchool year applying for?(Required)20262025What semester are you applying for?(Required)FallFall and SpringSpringSummerFaculty 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 OPPORTUNITYÂ鶹´«Ã½ 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 Â鶹´«Ã½ 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.CAPTCHA
