FOR OFFICE USE ONLY: To be completed by the Office of Financial Aid
Total Student Award Package: _____________________ Earn Type: _______________________
W&J College-Office of Financial Aid
Student Work Authorization Form
2020-2021
T
o be completed by the student
Student Name: ____________________________ Student ID: _________________________
I agree to follow the regulations of the Work Study program, and accept the position as described by the
Supervisor.
Student Signature: ____________
_________________________________________________________
To be completed by the hiring supervisor
The purpose of this job is to assist in the student’s workplace skill development. I agree to follow the
regulations of the Federal Work Study/Campus Employment Program.
Position: _______________________________________ Wage Rate: ___________
___________
Anticipated Number of Hours per week (not to exceed 10): ______
______
Department: __________________________________________________________________________
Department Account # to be paid from: ____________________________________________________
Hiring Supervisor: _____________________________________________
_________________________
Alternate Supervisor: ___________________________________________________________________
Supervisor Signature: __
_________________________________________________________________
This form must be scanned/emailed to amanno@washjeff.edu, please use the subject ‘student work
authorization form’
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