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Student Employment Change Form

This form is to be used by supervisors to request a change in current student’s employment information.

(Examples of Changes: Pay rate change, Cost Center change, FWS employment to UE employment, UE employment to FWS employment, Separation of Student)

 

 Effective Date of Change


 

,

 

 

 



 


 


 

(if applicable)
 


 


 


 


 


If separating student, indicate last day worked:


 

,

 

Requestor’s Information