SES Request for Additional Authorization

Student Employment Services Request for Additional Authorization
Student Name*

First NameLast Name
Student ID Number*
900 #
Position Code*
Job Title*
Department*
Supervisor Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
What are you requesting?*

Pay rate changeChange in workable hours
If requesting pay rate change: What is student's current pay rate?
If requesting pay rate change: What do you want student's pay rate to be changed to?
Justification of pay rate change:
** Please use specific examples
If requesting change in hours: How many hours was student working before?
If requesting change in hours: How many hours do you want the student to work now?
Justification of workable hour change:
** Please use specific examples
I understand that all student employment is based on fund and position availability and am aware that if a student exceeds his/her total awarded funds, my department is responsible for ensuring that the student is compensated for additional work. Upon approval of this request the above changes will go into effect at the beginning of the following month, not before, and I understand that there is no retro pay.
Supervisor Signature*

Clear
Should be Empty:

Student Employment Services Request for Additional Authorization