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Student Employment Referral OR Wage Increase

This form is required for ALL work-study OR temporary service student employees, each school year.

● Authorizes the student to work for the school year (until the day of graduation).
● An additional form must be submitted for each student working during the summer.

  • This student has *
    This student has

    Previous employment does NOT include BASC, NY State Employee Payroll (GA/TA), RA's or BSG. If unsure, please call Student Employment at x5815

  • Students new to work-study OR temporary service positions must complete their work authorization BEFORE they can start working for you.

    Please advise your new student employee they will receive an email with the subject, “Student Employment Paperwork Required!“ which explains what the student must do, including:

    1. Schedule an appointment about required paperwork.
    2. Gather required identification/documentation from this List of Acceptable Documents. The documents must be original. We CANNOT accept photocopies or faxes and the documents CANNOT be expired.

  • Student Legal Name Student Legal Name *
  • Must be 9 digits.   Currently Entered: 3 digits.
  • Supervisor Name Supervisor Name *

    Only an employee of SUNY Brockport may supervise. The listed supervisor is whoever will be approving timesheets.

  • Must be a email.

  • Payroll *

    Work-Study eligibility and award amount is determined by the Financial Aid Office.
    ● The student may see their eligibility using Web for Banner (PIN required).
    ● Supervisors can check for eligibility in Group_Student Employment Supervisors_GRP in Teams (Work-Study channel, files, FWS Eligible Files) or email with the student's 800# to verify.

  • Work-Study Account # *
    Work-Study Account #

    For Work-Study only.

  • Must be a number between 1 and 99

    Required field to identify department for Work Study.

  • Must be a number between 100000 and 999999

    For Temporary Service (TS) only.

  • Must be 2 digits.   Currently Entered: 0 digits.

    Required field to identify department account sub-code for Temporary Service.

  • For Dept. Use (not a required field)

  • All jobs must be posted in Handshake.

  • Must be a number between 12 and 24

    Student Employment Wage Rate must be between $15.00 (minimum) and $25.36 (maximum).

  • Actual Starting Date Actual Starting Date * / /
    Pick a date.

    ● Enter the actual date this student will start work OR TRAINING.

    ● First-time student employees must bring acceptable documents for I-9 to Student Employment (scheduling an appt through Handshake) BEFORE they begin working.

  • For any information, you would like Student Employment or Payroll to be aware of.

  • Name of Staff Member Completing This Form (If not the Supervisor above.) Name of Staff Member Completing This Form (If not the Supervisor above.)

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Brockport, NY 14420