REQUEST FOR APPROVAL OF ADDITIONAL EMPLOYMENT
BY RESIDENT ASSISTANT/DIRECTOR
In accordance with expectations stated in the Resident Assistant/Director Position Description
internships, student teaching or other employment positions must be approved by Residence Life
professional staff. Outside employment should not exceed 15 hours per week. Please complete this form
and submit it to your direct supervisor.
Name __________________________________________________ Date: _______________________
Requesting Approval of (Check All that Apply):
_____ Off-Campus part time employment
_____ Internship
_____ Other
_____ Academic Requirement
1. Outline your requested work schedule. Include how many hours per week you anticipate working,
when you anticipate working those hours, what travel time will be necessary?
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2. Will this position allow you the flexibility to change/cancel hours if necessary due to academic or
RA/D commitments?
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By signing here I indicate that the information provided above is accurate to the best of my knowledge. I
will keep my supervisor informed of any major changes to this request and understand that if approved
additional employment conflicts with my academics or the Resident Assistant/Director position I may be
asked to resign from either the additional employment or the Resident Assistant/Director position.
RA/D Signature _________________________________________________________________
FOR OFFICE USE ONLY:
________________________________
Professional Staff Supervisor’s Title
APPROVED ___________
______________________________________________
Professional Staff Supervisor’s Signature
DECLINED ___________