Online Change of Supervisor Form

Student information:

First Name: Last Name:
Student ID:
Email Address:
Job Title:
Department:

Current Supervisor Information:

Supervisor Name:
Supervisor Email Address:

Does this supervisor need to be removed from the supervisor listserv?
Yes
No

New Supervisor Information:

New Supervisor Name:
Supervisor Email Address:
Supervisor ID:

Does this supervisor need to be added to the supervisor listserv?
Yes
No

Effective Date:

Reason for change:

By submitting this form, you agree to the following:

I acknowledge that students may work up to 7.5 hours per day and 37.5 hours per week. Overtime earnings cannot be paid out of work award dollars and I will discourage a student from working overtime hours. I understand that my department will be responsible for overtime earnings and if a student is working in more than one department, it is the responsibility of the department where the overtime occurs to assume responsibility for the earnings. I certify that all timesheet submissions made for the academic year will be accurate and signed by myself and the employee.

I understand that the work award is awarded on a yearly basis and it is my responsibility to monitor student earnings. I further understand that a student may become ineligible for the work program at any point in the academic year and that any overpayment of the above award will be debited from department personnel funds.