Rate Change

DO NOT USE THIS FORM IF THE STUDENT IS NOT WORKING FOR YOU AT THIS TIME. USE THE STUDENT EMPLOYMENT CARD TO HIRE A STUDENT FOR A NEW JOB. STUDENTS MUST COMPLETE ALL APPROPRIATE PAPERWORK TO GET PAID. EMPLOYERS ARE REQUIRED BY FEDERAL LAW TO KEEP A RECORD OF THE HOURS WORKED BY THE STUDENT AND SEE THAT WORK DOES NOT INTERFERE WITH HIS/HER CLASS.

THIS COMPLETED FORM MUST BE RECEIVED BY OUR OFFICE 14 DAYS PRIOR TO THE SCHEDULED PAYDAY.

    Student Information

    This is a required question
    This is a required question

    Job Information

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Employer Information

    This is a required question
    This is a required question
    This is a required question