Application for Position as

Alpha of Clovia’s Housemother

(print off, and send to address below)

Date:                                                            

Name:                                                                                                                                                             

First                         Middle                     Maiden                          Last

Current Address:                                                                                                                                       

City                                                 State                                                Zip Code

Telephone Number:                                                

In Case Of Emergency, Please Notify:

Name:                                                                                                                                                             

Current Address:                                                                                                                                       

City                                                 State                                                Zip Code

Telephone Number:                                                

Family Information:

Names of Children                      Address and Phone Number                                 Occupation

Educational and Personal Experience:

Circle the last year of school completed:

High School:    

Freshman                Sophomore               Junior                  Senior

College:            

Freshman                Sophomore               Junior                  Senior                  Graduate

Names of college(s) attended:                                                                                                               

Degree(s) received and dates:                                                                                                                

List any additional courses taken, whether for credit or personal satisfaction

(correspondence, workshops, homemaking, etc)

                                                                                                                 Date:                                             

                                                                                                                 Date:                                             

                                                                                                                 Date:                                             

How familiar are you with Kansas State University’s life and activities?

Very familiar                                 Somewhat familiar                                    Not familiar                    

How did you gain this understanding?            (please check all that apply)

Personal experience                                                 Work experience                                      

Husband’s experience                                           Reading and conversation                     

Children’s experience                                           Other                                                            

What are your interest and hobbies?

Fraternity/Sorority Membership(s):                                                                                                        

Please list church, club, or organizational affiliations:

Name of Organization                                          Dates active                         Offices or Committees

Occupational Information:

List all positions that you have held, beginning with the most recent. Give addresses, including city and state, and the approximate date of your employment.

Position                                         Location                                                      Dates Employed

Summarize the duties of the position most closely related to this housemother position.

What special training experience have you had as preparation for this position?

Have you done any work with young people, such as scouting, 4-H, etc.?

What experience do you have in foods, menu planning, budgeting, and keeping books?

What is your attitude toward chapter government and discipline?

Briefly discuss your reasons for applying as the Alpha of Clovia’s Housemother.

What would be your greatest contribution to Alpha of Clovia’s members?

References:

Please give the names and addresses of at least three references from whom we may obtain recommendations regarding your character, experiences, and ability. Include at least one recent employer, if applicable. If your credentials are on file at any college placement office, please indicate this.

Name                                               Address                                                       Phone Number

When would you be available for an interview?                                                                               

How did you hear about us?                                                                                                                    

Please attach a resume. Other comments may be added to back of this application.

Instructions:

The completed application should be mailed to:

Alpha of Clovia’s Housemother Search

Attn: Becky Thiessen

1200 Pioneer Lane

Manhattan, KS 66502

If selected by the interviewing committee, an interview date in Manhattan will be arranged. The committee will make the final employment decision and/or recommendations to Alpha of Clovia Chapter, and then you will be informed of our decision.