Student Assistant Only-CEM/INE
This form is to be used for undergraduate students only
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Submitter Name *
Supervisor Name. *
Supervisor ID# *
Student Name *
Student ID#
Chart of Pay Periods
Start Date (please use the start of a pay period when possible) *
MM
/
DD
/
YYYY
End Date *
MM
/
DD
/
YYYY
Hours per week (up to 40 in the summer, 20 during a semester) *
Required
Required
Fund/Org *
Grant Manager *
Required
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