20-21 Graduate Assistant Employment Authorization
Student Information
This section is to be completed by the hiring supervisor.
Student’s Full Name: Student ID Number:
Student’s Street Address:
City: State: Zip Code:
Student’s Date of Birth: Student’s Email Address:
Student’s Home Phone Number:
Student’s Alternate or Cell Phone Number:
Graduate Admission Acceptance: Yes No Academic Program:
Graduate Financial Aid Application Submitted: Yes No
Work Application Submitted: Yes No*
*If no, student must be advised to submit a Graduate Financial Aid Application and Work Application.
Note: If your position requires an additional Supervisor/Employee Contract, attach a signed copy for our records.
GA Employment: Department Information
Position Title: Department:
Compensation Package
Complete only if different than what was reported on GA Requisition Form on file with Student Financial Assistance.
Name of Supervisor: Telephone:
Employment Contract Period
Start Date: End Date:
(Contract dates anytime between 7/1/20 and 6/30/21)
Signatures
Supervisor: Date:
GA Coordinator, SFA: Date:
