Student Update – Request Form Student Employment Updates Step 1 of 3 33% Preparer Information Preparer Name(Required) Your name First Last Preparer UW Email(Required) Your UW email address Alternate Contact In the event of your absence, who should be contacted? First Last Alternate Contact UW Email Alternate contact's UW email address EO Assistance(Required) Did you consult with or receive assistance from an Executive Office Shared Environment team member prior to filling out this form? No Yes Team Member Name First Last Student Employee Information Student Employee Name(Required) First Last Student Employee Email(Required) Student Unit(Required) -CHOOSE ONE-Academic Personnel (AP)Academic and Student Affairs (ASA)President (PRES)Provost (PROV)Faculty SenateHealth Sciences Services (HSS)Division of Campus Community Safety (DCCS) AP Sub-Units(Required) -CHOOSE ONE-AP: CoreAP: Ops, AHR, PIMAP: Ops ISOAP: Faculty Advancement ASA Sub-Units(Required) -CHOOSE ONE-ASA: Academic Technologies (AT)ASA: AdmissionsASA: AdvancementASA: Center for Teaching and Learning (CTL)ASA: CoreASA: Financial AidASA: Information Services (ASA-IS)ASA: International Student ServicesASA: RegistrarASA: Strategic Initiatives DCCS Sub-Units(Required) -CHOOSE ONE-DCCS: CoreDCCS: SafeCampusDCCS: Emergency ManagementDCCS: UWPD HSS Sub-Units(Required) -CHOOSE ONE-HSS: Academic Services & Facilities (AS&F)HSS: CoreHSS: Interprofessional Education (IPE) PRES Sub-Units(Required) -CHOOSE ONE-PRES: Board of Regents (BOR)PRES: CorePRES: Environmental Health & Safety (EH&S)PRES: Internal Audit (IA)PRES: OmbudPRES: Population HealthPRES: University Rules & PolicyPRES: UWINCO Action Request Employment Changes(Required) Extend Employment Change Pay Rate Extend Employment WITH Pay Rate Change Work Study(Required) Is this student currently in a work study position? No Yes Current Employment End Date(Required) MM slash DD slash YYYY Proposed Employment End Date(Required) No more than one year beyond the current end date. MM slash DD slash YYYY Current Hourly Pay Rate(Required) Proposed Hourly Pay Rate(Required) Effective Date(Required) Date of pay rate change MM slash DD slash YYYY Justification(Required) Provide justification for these changes to this student's employment. Documentation Upload any documentation that would be helpful to EO HR team when reviewing this request. Drop files here or Select files Accepted file types: doc, docx, pdf, jpg, jpeg, xlsx, xls, Max. file size: 15 MB. Additional Information Provide any additional information that would be helpful to EOHR Team when reviewing this request. Certification(Required) I certify the student will maintain eligibility for student employment for the requested extension period. For further information about student employment eligibility, please review the EO HR Student Hiring & Recruiting, under the Student Employees and Academic Student Employees.