721 Cliff Drive • Santa Barbara, California 93109-2394 • Phone (805) 965-0581 • Fax (805) 965-0151
\\fs3.sbcc.local\home\gamiguel\documents\reference materials\international student ss directions\social security request letter for f-1 workers.doc 7/1/2020
To: Social Security Administration
Re: Social Security Card for ________________________________________________________
(Student’s Name – Please Print)
Date: _____________________________
The above named student is enrolled in our International Students Program, and has been offered
employment at Santa Barbara City College. The student needs a Social Security card with a notation of
“Valid for Work Only with DHS Approval” so that the student can accept employment with the
following campus office/program.
Please enter name on the Social Security card as it appears on legal documents.
* * * * PLEASE PRINT INFORMATION * * * * *
Department offering job: __________________________________________________________
Student’s Immediate Supervisor: ____________________________________________________
Supervisor’s Phone Number: 805-965-0581 ext. _______________ Other ___________________
Student’s Job Title: _______________________________________________________________
Student’s Job Description: _________________________________________________________
_______________________________________________________________________________
Desired Start Date: ____________ Number of hours per week: ____________
Supervisor’s Signature: ____________________________________________________________
* * * * * HR/LA Employer Contact Information * * * * *
Employer’s Identification Number (EIN): _________________________________
Employer’s Telephone Number: 805-965-0581 ext. ________________
Employer’s Signature (original): ________________________________________
Employer’s Title: ____________________________________________________
Date: ______________________
Thank you very much for your cooperation.
Note: Please give student a receipt to verify issuance of
Social Security number for employment purposes.
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