RECREATIONAL SPORTS AND SERVICES USE ONLY
Hiring Supervisor: ______________________________ International Student: ____Yes ____ No
Confirm Birth Date: ____________________________ START DATE: ________________________
Other Campus Employment: _____Student _____Undergraduate Assistant %_____
_____Graduate Assistant %_____ _____Civil Service
_____Faculty _____Administrative Professional
Account Position _____206281 _____210001 _____210002 _____210003 _____210004
Rate of Pay $__________ $__________ $__________ $__________ $__________
Account Position _____210005 _____210006 _____210007 _____210008 _____210009
Rate of Pay $__________ $__________ $__________ $__________ $__________
Account Position _____210010
Rate of Pay $__________