Student Employee Request Form

Student Employee Designation
- Work Study Position
- Budgetary Positition
- Intern
- Graduate Assistant
Is the student a returning employee to your department?*
- Yes
- No
Student Name*
First M.I. Last
Student ID Number*
Anticipated Start Date
MM slash DD slash YYYY
Department
Job Title
Remove Job Posting
- Yes
- No
Supervisor
Payroll Account to be Charged
Delegated Timecard Manager
Delegated Timecard Manager Title
Brief Description of Skills Needed
If student employee needs an .edu account or any other special privilege, you are responsible for submitting a stat ticket to IT with the following information:
- Name
- Student ID#
- Building/Office Keys
- Computer
- Software/Network Access
- Phone
Note: This form is to be completed at the beginning of employment and/or the beginning of each academic year.
By initialing below, I acknowledge my understanding that I am responsible for managing and verifying student worker tasks, hours and employment. Additionally, I acknowledge responsibility for providing meaningful work for any and all students who hold positions within my department. I understand that failure to provide any of the above may result in disciplinary action up to and including my termination of employment.
Supervisor Name
Supervisor Email
Supervisor Initials*
Date*
MM slash DD slash YYYY
Captcha