Florida Community College at Jacksonville s4

FLORIDA STATE COLLEGE AT JACKSONVILLE RECOMMENDATION for Student Worker

Name: SS#:

I recommend this applicant for the position. I DO NOT recommend this applicant for the position. I would like to interview additional applicants for the position.

Interviewer (Print Name/Signature): ______Date: ______

FOR OFFICE OF STUDENT EMPLOYMENT This section is to be completed only if the applicant is SERVICES USE ONLY being recommended for the position. Student Employee Data: _____New Student _____Returning Student _____Change Termination Date: ______Position Title: Sex: __Male __Female Date of Birth ______Supervisor: __CWS __SA __Master Student __Intern __FWEP Department: Campus/Room: Start Date:______Rate of Pay:$______Job Number: Phone/Extension:

Program of Study: ______(circle one) AA AS PSAV Other

I understand as a student worker, I may have access to records, which contain individually identifiable information, the disclosure of which is prohibited by the Family Educational Rights and Privacy Act of 1974. I understand the intentional disclosure by me of this information to any unauthorized person could subject me to criminal and civil penalties imposed by law. I further understand such willful or unauthorized disclosure also violates FSCJ’s policy and could constitute just cause for disciplinary action including termination of my employment regardless of whether criminal or civil penalties are imposed.

We have both read and understand the work rules under the student worker program and agree on the job description, work schedule (not to exceed 20 hours per week), time recording/reporting and payment arrangements. We understand that I, the student worker, must maintain a minimum of 6 credit hours each semester and a minimum GPA of 2.0 throughout my entire employment period.

We will complete a schedule indicating the classes and hours the student worker will be working each semester. I understand as a student worker that if I submit fraudulent hours on my time card, I will be terminated from the student worker program.

Supervisor: I acknowledge that permitting the student to exceed the maximum 20 hours per week employment contract could result in the exhaustion of the student’s financial aid award and endanger their employment status. If this process continues, I understand the position can be terminated and/or the student may be re-assigned to another department or supervisor.

Student’s Signature: ______Date: ______

Supervisor’s Signature: ______Date: ______

Form OSE 002 Form OSE 002