OFFICE OF STUDENT FINANCIAL AID

Federal Work-Study Program

Federal Work-Study (FWS) Employer Application/Renewal Form

Fall 2015 - Spring 2016

Section 1.

All staff who participate in the FWS program must adhere to all the policies and procedures in the FWS handbook. The FWS handbook is available on-line at By signing below, the FWS Contact and FWS Payroll Officer agree to abide by all policies outlined in the FWS Employer Handbook and to ensure that all FWS supervisors and employees abide by these policies. Any unauthorized earnings will be billed to your department’s Labor and Assistance Account.

Please complete the application, print, and provide the requested signatures:

Department Name: (Please type out the full departmental name. No acronyms)

FWS Account #: 01-444- - 2074

*(If you are a new FWS employer and the FWS account field is blank, we will establish an account for your use.)

Mailing Address:

Section 2.

Have you submitted a FWS Participation Agreement? Yes No

Have you established a Data Warehouse Account with FWS access? Yes No

Labor & Assistance FRS Account #: – 2075 Check Distribution Code:

Employer FWS Employer Contact:

Name: Phone:- -

Email: UID: Fax #:

- -

Employer FWS Payroll Officer:

Name: Phone:- -

Email: UID: Fax #:

- -

Section 3.

1.How many student employees do you plan to employ for each of the coming semesters?

Minimum FWS Students / Maximum
FWS Students / Planned
L&A Students / Total Students
Undergraduate employees per semester: / / / /
Graduate employees per semester: / / / /

2.Please check each area in which you plan to offer student positions for the coming semesters or summer terms.

AccountingOffice/ClericalTutoring

Computers/ ITResearch/LaboratoryGeneral Labor

Other (specify):

**Please type in the text box and provide an attachment if needed**.

3.Briefly describe your anticipated need for FWS student employees for the coming fall and spring semesters. Include any special learning opportunities, special needs, and any other important information pertaining to your department (such as loss in staff, expansions, etc.) that you would like to have considered as part of your application.

4.Approximately how many hours per week will each student be asked to work? Briefly describe your ability to offer a flexible work schedule as to accommodate student’s course and study needs.

5.What type of orientation, training, and supervision is offered by your department?

6.Briefly describe any opportunities for leadership and professional development your department offers your student (s) (i.e. training programs, opportunities to attend workshops, etc.).

Section 4.

1.In the year 2014 or 2015, did your department undergo reorganization (i.e. merge, name changes, or re-structure of administrative and payroll operations of any kind)?

Yes, our department experienced reorganization. Please note that in the event that your department has gone through reorganization of any kind, the FWS program should be notified. The FWS program will review the changes to ensure that the FWS program operations and FWS accounts meet FWS guidelines. The FWS program will review each department on an individual, case by case basis and will make accommodations accordingly.

No, our department did not experience reorganization. Please provide your signatures and submit all 2 pages.

********ONCE COMPLETED, PRINT FORM AND SIGN BELOW BEFORE SUBMITTING********

FWS Contact Signature:

FWS Payroll Officer Signature: