Off-Campus Federal Work-Study Referral Form

OFF-CAMPUS FWSP REFERRAL FORM -graduate

Off Campus (Student Employment Office processes 100% of students payroll and agency is billed a percentage.) All fields REQUIRED.

Student Information

First Name:

Last Name:

HUID:

Harvard E-mail Address

Phone

Local Address

School

Graduate School of Arts & Sciences
School of Dental Medicine
Design School
American Repertory Theater
Divinity School
Graduate School of Education
Law School
Medical School
Kennedy School of Government
School of Public Health

Job Information

Agency:

Job Title:

Job Description:

Period of Employment:

Term Time Summer

Job Start Date (mm/dd/yy):

Job End Date (mm/dd/yy):

Hourly Rate :

*(Please Note: The 2008 Summer FWSP wage guidelines for graduate students is $9.00-$17.15. Employers willing to pay more than the FWSP maximum per hour must do so on their payroll.)

Supervisor:

Supervisor's Email:

Supervisor's Phone:

Agency Information

Full Agency Address:

Mission of Organization:

Agency Source of Funding:

Billing Department:

Billing Address:

Billing Contact:

Billing E-mail:

Billing Phone:

We will email your Harvard email account and the supervisor provided within the next two business days to confirm your Federal Work Study Eligibility.
After you click on the "submit" button you will be provided with the links for additional tax information and other required documents.