Student Employment Request/Change Form

For MSSU Staff Completion Only
To be completed by requesting department.
All fields are required except email,special instructions and address information.

Student's First Name

Student's Last Name

Student's SID

Is this an international student?


Work Type
Student Help Work Study
Employment Start Date* *NOTE: Student must complete new hire paperwork prior to start date.

New Hire Paperwork Completion Date (internal purposes only):

Student's Job Title:

Index Code

Account Code

Grant Code

Department

Job Status
Primary Job Second Job Third Job Fourth Job
Primary Rate of Pay (if any)

Secondary Rate of Pay (if any)

Additional Rate of Pay (if any)

Special Instructions

Immediate Supervisor * *NOTE: Immediate supervisor will be responsilbe for approving the student's timesheet.

Work Phone of Immediate Supervisor xxx-xxx-xxxx

Departmental Approver (optional):* *NOTE: If a Departmental Approver is listed, both the Immediate Supervisor and Departmental Approver will be responsible for approving the student's timesheet.

Departmental Reviewer (optional):* *NOTE: If a Departmental Reviewer is listed, the Departmental Reviewer will only be able to view a student’s timesheet while it is pending approval. Departmental Reviewers will NOT be responsible for approving a student’s timesheet.

Enter your LioNet login information to sign form
Employee Username

Password