Gonzaga University Student Employment
CHANGE/TERMINATION PAR FORM
POSN #_____________
NAME:
__________________________________________________________________________
(Last)
STUDENT I.D. #:
(First)
________________________
(Middle Initial)
BIRTHDATE:
_________________________
CHANGE PAR SECTION (complete entire section)
FWS
□
Inst
GA
□
RA
□
DEPARTMENT:___________________________
FROM: ORGN Letters______________
FROM: Fund #____________________
FROM: Present Pay Rate___________
FROM: Present Hours______________
□
EFFECTIVE DATE: _______________
TO: ORGN Letters________________
TO: Fund #______________________
TO: New Pay Rate________________
TO: New Hours__________________
Reason _______________________________________________________________________
APPROVING SUPERVISOR = Person who will be reviewing and approving student time sheet.
APPROVING SUPERVISOR’S NAME & ID#: ______________________________
_________________________
SUPERVISOR’S PRINTED NAME
SUPERVISOR’S ID#
TERMINATION PAR SECTION
FWS
□
Inst
GA
□
□
RA
□
Department___________________________
Last Day Worked______________________
ORGN Letters _________________________
Fund # ______________________________
Reason for Termination: Please check one
□ Resignation □ Dismissal (List reason below)
_____________________________________________________________________________
_____________________________________________________________________________
__________________________________________________
SUPERVISOR SIGNATURE (make copy for records)
_________________
DATE
___________________
EXT.
_____________________________________________
STUDENT EMPLOYMENT OFFICE STAFF
_________________
DATE
___________________
EXT.