Co-op Student Wage and Hour Summary
Student name:
*
First Name
Last Name
Employer:
*
Date:
*
-
Month
-
Day
Year
Date
Program of Study:
*
Please Select
Agricultural Mechanics
Allied Health
Automotive Collison Repair
Automotive Technology
Building Construction Trades
Carpentry
Computer Integrated Manufacturing
Cosmetology
Culinary Arts
Dental Assisting
Diesel Mechanics
Early Childhood Education
Electrical Occupations
Electronics
Engineering Technology
Graphic Communications
HVAC
Information Systems Technology
Landscaping and Horticulture
Marketing and Web Design
Mechatronics
Medical Assisting
Veterinary Assisting
Welding
Hourly rate:
*
Gross Pay:
*
Fed Tax:
FICA S.S. Tax
State Tax:
Local Wage Tax:
Net Pay:
*
Attach a copy of your paystub.
*
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