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Fields
School of Music, Theatre & Dance
Student Worker Hiring Request
to be completed by the faculty supervisor
Faculty Supervisor Name
Prefix (optional)
First Name
Last Name
Faculty Supervisor Email
Position Details
Job Title or Description
Active Position Dates
Fall (9/5 - 12/15)
Break (12/16 - 1/1)
J-Term (1/2 - 1/30)
Break (1/31 - 2/6)
Spring (2/7 - 5/25)
Summer (5/26 - 9/4)
Other:
Other Value
select all that apply, student benefits are dependent on exact dates of work
Will this position require the following special circumstances?
handling hazardous chemicals (including paints, cleaners, etc.), working with or near noisy machinery, providing first aid, or handling human biological materials/specimens?
driving on university business more than 5 times a year?Required
check all that apply
Comments
Will multiple students be hired for this position with the same parameters?
Yes
No
How many students?
if there are more than 20 students, please include their names and email addresses in the comments section
Student Worker (1) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (2) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (3) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (4) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (5) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (6) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (7) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (8) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (9) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (10) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (11) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (12) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (13) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (14) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (15) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (16) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (17) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (18) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (19) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
Student Worker (20) Information
Student Name
*
First Name
*
Last Name
*
Student Email
*
Student PLU ID
I have verified that this student will be 18 years old or older before their first day of employment.
*
Yes
No
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