Career Services Center261 Schwartz Center, www.kent.edu/career, 330-672-2360

Grant Funded Student Employment Request FormPermission to Work Off Campus

A Principal Investigator (PI) who has received grant funding to support the employment of students at an off-campus location owned by another entity must:

1) Submit the Grant Funded Student Employment Request Form to Career Services for review.2) As appropriate, Career Services will direct the PI to consult with the Office of General Counsel to develop an Off-Campus Student Employment Agency Agreement, 3) If the employment of students is approved, the PI will submit the signed Agency Agreement to the Career Services Center in order to begin the hiring process.

Department and Supervisor/Primary Investigator (PI) Information

Supervisor/PI Name: Click here to enter text. Supervisor/PI Title: Click here to enter text.

Department Name & Address: Click here to enter text. Supervisor/PI Email: Click here to enter text.

Supervisor/PI Phone: Click here to enter text. Hiring Representative: Click here to enter text. (if different from supervisor)

Student Job InformationJob Title: Click here to enter text.

Typical Hiring Term(s): (check all that apply)

☐ Academic Year ☐ Fall ☐ Spring ☐ Summer

Grant Index: Click here to enter text.

Job Location (building/address): Click here to enter text.

How Candidates Typically Apply: (i.e., Flash @ Work, in-person, application on website, etc.)Click here to enter text.Hours Per Week: Click here to enter text. Number of Jobs Filled Each Year: Click here to enter text.

Hourly Pay Rate/Total Pay Amount: Click here to enter text. Background check required: No ☐ Yes ☐(If yes, retain results in departmental records.)

Do Student Employees Receive the Following:

Formal Orientation/On-boarding ☐ Yes ☐ No Formal Performance Evaluation(s) ☐ Yes ☐ NoStudent Employee Handbook ☐ Yes ☐ No Informal Performance Evaluation(s) ☐ Yes ☐ No (i.e., Ongoing feedback, etc.)

Job Duties/Responsibilities: Click here to enter text.

Student Qualifications: (i.e., Major, Class Year, knowledge, skills, abilities, etc.) Click here to enter text.

Job Learning Outcomes/Benefits to Student: (i.e., skills learned/developed) Click here to enter text.

Background check required: No ☐ Yes ☐ (If yes, retain background check results in departmental records.)

Time keep Method: (Provide a detailed description of how actual work hours for student employees will be tracked and verified, submitted to KSU, and retained according to records retention policies) Click here to enter text.

Email completed form to campusworks@kent.edu or fax to 2205706/10/2015