SECTION 1: HIRING MANAGER (Once complete, please give this form to the student and send them to Career Services (LRC-510).
Student’s Full Name:
Student’s Z#:
Department Name:
Org. Code & Cost Center:
Phone Extension:
Student’s Job Title:
Starting Employment Date:
Ending Employment Date:
Stipend Amount: OR Hourly Pay Rate:
Supervisor’s Name (print)
Supervisor’s Signature Date
SECTION 2: STUDENT (Bring this form to Career Services on LRC-510. If you’ve never worked on campus, please bring IDs for the I-9.)
Fall/Spring Summer
Have you completed registration? Yes No
Are you enrolled full-time? Yes No
Number of hours enrolled:
Are you a graduate student? Yes No
Are you an international student? Yes No
o If you checked yes, what is your I-20 expiration date?
(question #5 on your I-20 form)
SECTION 3: CAREER SERVICES (office use only)
GHN account is active
I-9 on file FICA Exempt
New Hire Reactivate
U.S. Citizen International Permanent Resident
Secondary Position - Time Card
Position Code:
Student Employment Representative: Date:
STUDENT EMPLOYMENT HIRING FORM
GRADUATE ASSISTANT/TEACHING ASSISTANT
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signature
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