Form Ose 003 - Student Worker Work Schedule Template
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1Florida State College at Jacksonville
Student Worker Work Schedule
Deerwood Center
Downtown Campus
Kent Campus
Campus/Center:
North Campus
South Campus
Other _____________
Fall
Spring
Summer A
Summer Cross
Summer B
Term:
Year: _________
Name:
Last 4 of Social Security Number:
Department:
Supervisor:
Office Location:
Office Phone:
Home Address:
City/State/ZIP
Home Ph:
Cell Ph:
Email Addr:
CLASS SCHEDULE
CLASS
MON
TUE
WED
THU
FRI
SAT
WORK SCHEDULE
DAYS
TIME IN
TIME OUT
TIME IN
TIME OUT
# OF WORK
HOURS
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
TOTAL WORK HOURS SCHEDULED PER WEEK
STUDENT WORKER’S SIGNATURE: _______________________________ Date: __________________
SUPERVISOR’S SIGNATURE: _____________________________________ Date: __________________
Forward original to Human Resources. Retain a copy for departmental file. Provide Student Worker with a copy.
Form OSE 003
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Parent category: Business