Requisition for Student labor

Hiring Office Section

ATTENTION: Student employees may not begin working until all required paperwork is submitted to the Student Employment Office AND the Student Employment Office has authorized a Start Date. Your department will be notified by the Student Employment Office when processing is complete.

Fiscal Year*

Format ( 20XX - 20XX)

Student Hire Type*

New Student Re-hire/ Continuing Student

International Student*

Yes No

Student Employee Information:

Legal Name*

First Name

Last Name

Student ID Number*

01234567

Phone*

(555) 123-4567

Student's Chaffey Email*

@panther.chaffey.edu

Position Information:

Job Title*

Job Location*

e.g. Math 121, Rancho Campus

Department/ Area*

Associate Superintendent/Division Lead*

Associate Superintendent, Business, Human Resources, Information Technology Services, and Workforce & Economic Development Associate Superintendent, Administrative Services and Emergency Operations Associate Superintendent, Instruction & Institutional Effectiveness Associate Superintendent, Student Services & Strategic Communications

Start Date*

End Date (last day of term)*

Pay Rate*

Appoximate hours per week**

*20 hrs. max during semesters & 35 hrs. max during non-attendance periods

Will student employee operate a district cart?*

Yes No

Web Time Entry Supervisor*

(First and Last Name)

Web Time Entry Supervisor ID Number*

XXXXXXX

Web Time Entry Alt. Supervisor

(First and Last Name)

Web Time Entry Alt. Supervisor ID Number

XXXXXXX

Prepared by*

First Name

Last Name

Prepared by Contact Number*

(909)652-XXXX

Prepared by Email*

@chaffey.edu

Area Manager*

First Name

Last Name

Area Manager's Email*

@chaffey.edu

Budget Information

ATTENTION: It is the responsibility of the requesting department to insure that student time sheets are using the correct funding source.

Funding Source Type 1*

Budget Number*

Percentage*

Position ID

Would you like to include an additional Funding Source?*

Yes No

Notes:

Date*

Budget Information 2

Funding Source Type 2*

Budget Number*

Percentage*

Position ID

Would you like to include an additional Funding Source?*

Yes No

Notes:

Budget Information 3

Funding Source Type 3*

Budget Number*

Percentage*

Position ID

Would you like to include an additional Funding Source?*

Yes No

Notes:

Budget Information 4

Funding Source Type 4*

Budget Number*

Percentage*

Position ID

Notes:

Student Employment Office

Grade Point Average*

Active Credits*

Student On-Campus Employment Eligibility*

Eligible Below Minimum Active Credits SAP Ineligible

Initial Federal Work Study Status*

Approved Incomplete Not Eligible

Request for Cart Operation Form*

Complete Incomplete

Other:

CalWORKs Work Study Letter of Verification*

No File Chosen

File uploads may not work on some mobile devices.

F-1 visa International Student Employment Letter (1 of 2)*

No File Chosen

File uploads may not work on some mobile devices.

Notes/Comments

Financial Aid FWS Verification

Semesters Approved*

Fall Spring Not Eligible

Other:

Fall Award Amount* $

Spring Award Amount* $

Award Start Date

MM/DD/YYYY

Award End Date

MM/DD/YYYY

Comments:

CalWORKs and NextUp Verification

CalWORKs Verification

Approved Pending Not Eligible

Other:

NextUp Verification

Approved Pending Not Eligible

Other:

International Student Center

F-1 visa SSN Request Letter (2 of 2)*

No File Chosen

File uploads may not work on some mobile devices.

F-1 Visa Students On-Campus Employment Eligibility*

Eligible Below Active Credits GPA

Other:

Notes/ Comments

Associate Superintendent Office

By typing your name below the undersigned approves of this work requisition and understands the obligations that accompany said approval.

Associate Superintendent

First Name

Last Name

For Student Employment Office Use Only

Requisition Status

Complete Pending Terminated

Name

First Name

Last Name