Yuba Community College District
2020-2021 FEDERAL WORK-STUDY REQUEST FORM
If you are interested in beginning a FWS job. If eligible, and if there are funds available in the program, we may offer
you an FWS award. Keep in mind that job placement depends on your skills, and in some cases, your availability to
work certain hours. An offer of FWS does not guarantee you a job. Fill out this form to your best ability and return
this form to the Financial Aid Office.
Note: Incomplete forms will not be reviewed. If you are offered FWS, we will communicate next steps to you via
email.
______________________________________________ __________________________
First MI Last Student ID#
______________________________________________ __________________________
Mailing Address Home Phone/Cell Phone
______________________________________________ __________________________
City State Zip Code Date of Birth
If you are requesting FWS to return to a previous FWS job or have been offered a FWS job, provide the following:
______________________________________________ ____________________________________
Employer Department
______________________________________________ ____________________________________
Supervisor’s Name Supervisor’s Phone #
I understand that even if I did not indicate interest in FWS employment on my FAFSA, by completing this form, I am
indicating interest in a FWS job. Further, I understand that all of the information above must be complete in order to
be considered for FWS. I also understand that this is a REQUEST, therefore, it may be denied. If I am awarded, other
aid may be cancelled or reduced to allow for awarding FWS.
Student Signature: _____________________________________ Date: _______________________
Lake County Campus
15880 Dam Road Extension
Clearlake, CA 95422
707-995-7923
Woodland Community College
2300 East Gibson Road
Woodland, CA 95776
530-661-5725
Financial Aid Offices
STUDENT INFORMATION
REQUEST INFORMATION
STUDENT CERTIFICATION
FOR FINANCIAL AID OFFICE USE ONLY:
SAR Date: _____________________________ FWS Question: Yes No Don’t Know
SAP Status: ____________________________ Appeal Filed: Approved Denied
Unmet Need: ___________________________ Enrollment Status: __________________________
Eligible for FWS Not Eligible for FWS
________________________ ____
_______
FA Tech Date
click to sign
signature
click to edit
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