HIRE FORM
OFFICE OF STUDENT EMPLOYMENT
2020-2021
LAST NAME FIRST NAME SIS STUDENT ID# NETWORK ID #
q New Campus Hire
(requires employment packet)
q Continuous Campus Hire
Start Date:
/ /
End Date:
/ /
q
Undergraduate (1410/1450)
q
Graduate (1420/1460)
q
International (1410/1420)
Exp. Graduation Date:
/ /
I. CHECK ALL THAT APPLY:
q SUMMER ONLY (05/10/20 - 08/22/20): q Registered 1/2 time in an 8-week course q Not Registered
q ACADEMIC YEAR (08/24/20 - 05/06/21) q FALL ONLY (08/24/20 - 01/08/21) q SPRING ONLY (01/11/21 - 05/06/21)
q NEW HIRE: For first time employment position with hiring department (requires job description)
q ADDITIONAL HIRE: For any student that has more than one position (requires job description)
q REHIRE: Student is returning to previous department
Please note: All first time hires must complete the required Employment Packet no later than the third business day from the hire date.
Included in this packet is the Federal I-9 Employment Eligibility Form which requires verification of identity and proof of eligibility to work
in the United States. These forms, along with a list of acceptable documents to select from, can be found at:
https://case.edu/financialaid/student-employment/student-employment-forms. First-time hires are not eligible to begin working until
this process is complete.
II. POSITION INFORMATION: Attach a copy of the job description for new hires
PROGRAM: q Federal Work-Study q Campus Employment/Non Federal Work-Study
AWARD AMOUNT: $ This award may be modified due to future changes in eligibility. (Confirmed by: )
Home Department OPR # Job Code: Hourly Rate: $
Supervisor’s Name: Emplid #:
Supervisor’s Network ID#: Phone #:
Person approving student’s time: Emplid #:
Supervisor’s / Coordinator’s Signature: Date:
Verify all employment forms have been submitted to the Office of Student Employment before beginning work. Students should return
this form to their supervisor(s) with the “Student Employment Use Only” section completed.
III. STUDENT CERTIFICATION: Student must read and sign: I certify that the information provided is true and accurate. I understand
that if I am employed as a student employee (Federal Work-Study or campus employment) at Case Western Reserve University, I must be
enrolled at least half-time. If for any reason I withdraw during the academic year, I must inform my supervisor immediately. Employment
will cease upon determined date of withdrawal. I agree to complete the required employment forms before beginning work; I understand I
cannot work over 20 hours per week during an academic semester or 40 hours per week during winter/spring/summer breaks, and
cannot work during my scheduled class times. I agree to abide by all rules and guidelines as published in the Student Handbook located at
financialaid.case.edu.
STUDENT’S SIGNATURE: Date:
Student Employment Use Only
Hiring process is complete?
q Yes q No q International student: must submit SS card by :
Student eligible to start?
q Yes q No
q Summer 2020 q Academic Year 2020-2021 Start Date: End Date:
EMPLOYMENT PACKET: q I-9 complete with acceptable ID q I-9 completed remotely q Withholding forms complete
q I-20/EAD expiration date Verified By:
Processor’s Initials: Date: Record #
q ACA q SSN
Office of Student Employment, Yost Hall, Room 412
stu-emp@case.edu
FAX: (216) 368-5054
Gloria D. Jenkins, Coordinator
