Work Study Employer Information
Please complete and submit this form via email to firstname.lastname@example.org.
• The form must be submitted at least two weeks before the end of each term.
• One form must be submitted per department.
TO BE DUPLICATED ONLY BY THE OFFICE OF THE REGISTRAR
Last Revised: August 24, 2018
Employer Contact Information:
The contact information provided below will receive ALL Work Study updates, including the reimbursement report
for the following term, and the combined total sum the department will be reimbursed for its approved students.
Email:Name of Employer:
RC charged to:
If for any reason, a student does not complete the full period of employment, I will notify the Financial Aid Administrator.
Signature of Employer:
PLEASE NOTE: All work study applications will begin to be processed after day 10 of the semester. Processing time
is 2 weeks from when the student submits their application online through Student Center.
Select term in which the students listed below were employed by your department:
Fall Winter Summer
Student # Student’s First Name Student’s Last Name Department Student Position Title
PLEASE NOTE: This list must be done per term. If the list is not received via email at email@example.com at least
two weeks prior to the end of each term the students will not be eligible for the Work Study Program.