Fillable RequestAssignmentStudentLabor STUDENT EMPLOYMENT

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RequestAssignmentStudentLabor STUDENT EMPLOYMENT

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ARKANSAS TECH UNIVERSITY
FINANCIAL AID OFFICE
Request/Assignment for Student Employment
I.
Name_____________________________________________SS#__________________________
June only ___hrs/wk Fall semester ___hrs/wk
$__________max earnings $__________max earnings
1st summer term ___hrs/wk Spring semester ___hrs/wk
$__________max earnings $__________max earnings
2nd summer term ___hrs/wk Fall & Spring sem. ___hrs/wk
$__________max earnings $__________max earnings
Beginning date:_______________Ending:___________________ WS___ NWS___ $6.25___
*OTHER $_______ (SPECIAL RATE) SIGNATURE (V.P.ADMIN/FINANCE) ___________________
**S.S.FELLOWSHIP ($7.00) **SIGNATURE (V.P. ACADEMIC AFFAIRS) ______________________
Budget Title:_____________________________Position #__________________________
Supervisor:_______________________________Department:____________________________________
(if different from budget title)
Purpose of Job__________________________________________________________________________
Duties & Responsibilities_________________________________________________________________
Job Qualifications_______________________________________________________________________
____________________________ ________________________________________
Supervisor's signature Dean's signature (if required by Dean)
***************************************************************************************
FINANCIAL AID OFFICE USE ONLY
Student's assignment is approved as requested. Student's maximum earnings are
$____________ Signature:_____________________________Date ____________
************************************************************************************
CC: PLEASE PRINT YOUR NAME AND BUILDING
SUPERVISOR'S NAME_____________________________ BUILDING___________________________
PART II INCREASE/DECREASE
Please INCREASE/DECREASE this assignment effective DATE ___________________
______total hrs per week $ ___________maximum earnings
Comments_______________________________________________________________
________________________________________________________________________
Supervisor's Signature__________________________________Date_________________
*******************************
ADJUSTED MAX EARNINGS $___________ APPROVED___________________
*******************************
Additional INCREASE/DECREASE effective DATE__________________________
_______total hrs per week $ ___________maximum earnings
Comments_______________________________________________________________
________________________________________________________________________
Supervisor's Signature__________________________________Date_________________
*****************************
ADJUSTED MAX EARNINGS $____________APPROVED___________________
*****************************
PART III TERMINATION OF ASSIGNMENT (ATTACH FINAL TIME /SHEET)
Please terminate this assignment effective (last date of work)_____________________
Reason for termination: __________________________________________________
Comments_______________________________________________________________
________________________________________________________________________
Supervisor's Signature: __________________________________________________
*************************************************************************
FINAL MAXIMUM EARNINGS $___________ APPROVED___________________
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RequestAssignmentStudentLabor STUDENT EMPLOYMENT

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Completed 12 February 2020

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