Please complete this form to request the number of students needed for each available position.
Only the positions listed below will be honored. THIS AGREEMENT MAY NOT EXTEND
BEYOND MAY 13, 2016.
By returning this form, the department accepts responsibility for any earnings that exceed the student’s work study award amount.
: ___ Location: ___________________________
1.
JOB TITLE:
JOB DESCRIPTION:
EXPERIENCE REQUIRED:
CONTACT PERSON:
WAGE RATE:
2.
JOB TITLE:
JOB DESCRIPTION:
PHONE NO.
NUMBER OF STUDENTS REQUESTED:
EXPERIENCE REQUIRED:
CONTACT PERSON:
WAGE RATE:
3.
JOB TITLE:
JOB DESCRIPTION:
EXPERIENCE REQUIRED:
PHONE NO.
NUMBER OF STUDENTS REQUESTED:
CONTACT PERSON:
WAGE RATE:
4.
JOB TITLE:
JOB DESCRIPTION:
PHONE NO.
NUMBER OF STUDENTS REQUESTED:
EXPERIENCE REQUIRED:
CONTACT PERSON:
WAGE RATE: NUMBER OF STUDENTS REQUESTED:
PHONE NO.
Page 1 of 2

MISSOURI STATE UNIVERSITY
FEDERAL WORK STUDY CONTRACT
ACADEMIC YEAR 2015-2016
The purpose of the Federal Work Study Program is to provide for direct educational expense of the student through employment. The program is funded 75% by the Department of Education and 25% by the university or agency. This agreement may be mutually discontinued at any time by either the department/agency or the Student Employment
Office. This agreement may not extend beyond MAY 13 TH , 2016 .
1.
Students must be enrolled in and complete a minimum of 6 credit hours .
2.
The amount of hours a student may work per week should be in accordance with the amount of the work study award and the 1,000 hour policy limit. Additionally, academics should be a priority. Student cannot be asked to miss a scheduled class for the purpose of work study employment.
3.
Submit an online Work Study Clearance form for every student that you are hiring as a work study student in your office. A student will not be able to work until you receive an email stating the student has been cleared.
4.
Wages will be determined by the department, in accordance with the Student Employment Handbook guidelines; and will be at least federal minimum wage.
5.
The University pays students twice per month based upon authorized time submitted by the department.
6.
Any Work Study employee who receives an on-the-job injury must give written notice to the Human Resource
Department as soon as possible after the accident in order to file Workman’s Compensation. The state expects a report within 24 hours.
7.
Forms used in the Federal Work Study Program are:

Signed Contract: document outlining job description and program regulations.

Work-Study Clearance Form located on the student employment website.
8.
The University does not normally withhold FICA contributions from the student’s payroll periods during the enrollment. However, FICA contributions are made when school is not in session. FICA contributions are also made for student when their enrollment is less than six hours during the academic year or less than three hours during the summer term.
The department accepts responsibility for the regulations above and accepts any work-study wages paid over the award amount.
Authorized Signature for the Department/Agency
Coordinator, Student Employment
Missouri State University
Please campus mail, email ( WorkStudy@MissouriState.edu
), or fax (6x7608) the completed and signed form to Student Employment by July 31, 2015.
Page 2 of 2