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Student Employment Referral

  • 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.

  • NOTE: Fall temp service student hires will NOT be processed until Student Employment receives VP approval.

    Please submit the Fall Request to Hire Temp Service Student Employees to receive VP approval.

  • 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 x2159

  • 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: 0 digits.
  • Supervisor Name Supervisor Name *

    Only an employee of The College at Brockport may supervise.

  • Must be an @brockport.edu email.

  • Payroll *
    Payroll

    Work-Study eligibility and award amount are determined by the Financial Aid Office.
    ● The student may see their eligibility by using Web for Banner (PIN required).
    ● Supervisors can check for eligibility in filecity2/ COLLEGE_WORK_ STUDY_PROGRAM or in Handshake as applicants apply to the job posting.

  • 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)

  • Student work location is *
    Student work location is
  • Must be a number between 11 and 24

    Student Employment Wage Rate must be between $11.80 (minimum) and $24.37 (maximum).

    Minimum wage is expected to increase to $12.50/hour starting on 12/24/2020.

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

    ● Enter the actual date this student will start work OR TRAINING.
    ● Work-study students start 8/28/2020 (and after).
    ● First time student employees must bring acceptable ID to Student Employment BEFORE they begin working.

  • For any information you would like Student Employment to be aware of. For example, work study switch.

  • 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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