Graduate Assistant - Approval to Work Additional On-Campus Job Form

Graduate Assistant - Approval to Work Additional On-Campus Job Form

Student First Name*

Student Last Name*

Student ID#*

Student's Email*

Degree Program/Major*

Assistantship Department*

What department is the student's Graduate Assistantship with?

GAs Academic Advisor or Graduate Coordinator*

Please list the name of the student's advisor or graduate coordinator. They will need to approve that the student is in good academic standing and can devote the time away from their studies to work the additional hours.

GA Advisor's or Graduate Coordinator's Email*

Additional On-Campus Job Information

Department or Unit for Additional Work*

Effective Date: From*

Effective Date: To*

Expected Work Hours per Week*

Brief Description of Duties*

Index Number*

The stipend for hours worked will be changed to this index.

Additional Work Supervisor's Name*

Who will be supervising the student during the additional work (work over the break or summer)?

Additional Work Supervisor's Email*

For International Students Only

Please check the box if you are an International Student

DSO's Approval for International Student

Additional Information

File Attachments

Please attach any additional information.

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