Note: You must fill out this form for each job requested (the job may be filled by more than one student).

If you have any questions while filling out this form, please refer to Tips For Using This Form (opens in a new window), prepared by Human Resources.

Job Information:

Position Title:
Job Location:
Job Supervisor:

Supervisor Title:

Timesheet Approver:

Designee Title(s):

Office Building Location:





Note: Minimum wage increases to $12.50/hr on 1/1/2021.

Fall 2020 – ($11.80/hr)
Spring 2021 – ($12.50/hr)
Summer 2021 – ($12.50/hr)
Academic Year

Is this a new position:

Yes No

Would you like this job posted:

Yes No


Job Responsibilities (be as accurate as possible):

Special Skills Needed:

Applications Materials:
(i.e. resume, cover letter, interview—will you require any/all?)

Detail Expected Hours To Be Worked:
(For example: "Mon, 8-12; Tues 8-12 & 5-7")

Budget Information:

Total Students Requested:

Start Date:

End Date:

Total Number of Weeks:

Number of Students/Week:

Students X Hours/Week = Weekly Hours

Weekly Hours X Rate/Hour X Weeks = Total requested

Budget Account Number:


Preparing Students to Lead Lives of Consequence.