Student Name: _________________________________________WIN:____________________
PLEASE COMPLETE THE FOLLOWING SECTIONS IN ORDER
EMPLOYMENT CANNOT BEGIN UNTIL ALL PAPERWORK IS APPROVED.
STEP 2: TO BE COMPLETED BY THE STUDENT
• I MUST complete all other employment paperwork PRIOR to the start of work.
• I can work a maximum of 20 hours per week during the academic year and 30 hours per week during
the summer term. Work cannot occur during class time.
• My earnings cannot exceed my Work Study award.
• My award for Federal Work Study may be adjusted to reflect estimated earnings.
• A student is permitted to work a maximum of 2 jobs per term.
Student Signature ____________________________Phone_____________________Date____________
STEP 3: TAKE TO HUMAN RESOURCES FOR VERIFICATION OF THESE DOCUMENTS IF YOU HAVE NOT
WORKED AT WILKES UNIVERSITY IN THE LAST 13 MONTHS OR IF YOUR INFORMATION HAS CHANGED
_____I-9 Form (with 2 forms of original ID)
_____W-4 Tax Form
_____Direct Deposit Form
_____Local Earned Income Tax Residency
Certification
_____Student Workers’ Compensation “Notice
of Rights and Duties”
_____Acknowledgment of University
Policies
______________________
________________________________________
Signature: Human Resources Representative
Date
STEP 1: TO BE COMPLETED BY THE APPROVING DEPARTMENT SUPERVISOR
Dept:___________________________ Federal ORG Code: 902 Institutional ORG Code:_______________
Position Code: Federal Work Study C___________ Position Code: Institutional Work Study W___________
Hourly rate: (Select and initial) □ $7.50 □ $8.00 □ $8.50 □ $10.00
Requested Start Date_________________ End Date_________________
Dept. Supervisor (print)_________________________ Signature _______________________ Date_________
Time Trak Supervisor (print) _____________________ Signature _______________________Date_________
RETURN TO THE HUMAN RESOURCES OFFICE WHEN ALL SECTIONS ARE COMPLETE
NBAJOBS ________ Payroll________ Student/Supervisor_________ Hours Per Year_______ FOAP________________
WORK STUDY APPLICATION
(July 1,
2019 – June 30, 2020)
Check here if you are a student with a disability and need accommodations for your employment.
I understand that:
_____________________
Approved Start Date
