FEDERAL WORK STUDY CONTRACT Acceptance of Federal Work Study Award/Assignment Conditions of Employment 1. It is the responsibility of the student and supervisor to monitor the hours worked by the student to ensure compliance with College regulations. 2. Your signature acknowledges that you understand that at NO TIME are you permitted to work more than twenty (20) hours per week or over the above stated award amount. 3. Your signature acknowledges that you understand that at NO TIME are you permitted to work during scheduled class times. Violations will result in termination from the FWS program. 4. This contract is subject to provisions of the policies and regulations governing student employees. 5. Jarvis Christian reserves the right to terminate this contract, if the interest of the College requires such action. 6. The student must maintain satisfactory academic standards and meet the full requirements of the job as outlined by the immediate supervisor. 7. The student worker and supervisor agree not to modify conditions of this contract without prior approval of the Office of Student Financial Aid. 8. The student worker is required to report to his/her work study assignment on time and report to the supervisor or approved designee. The Supervisor must approve the hours by the payroll due date. Failure to do so will delay payment on the scheduled payroll date; I have received a copy of the payroll schedule. 9. I understand if I have not worked by mid-point of the term my remaining FWS will be cancelled. Cancellation of FWS is for the academic year. 10. I have read the Jarvis Christian FWS Handbook 11. Funds Disbursement Options ( Please select one): Option 1: Credit FWS earnings to my student account and receive a check for any balance Option 2: Receive a check for the full amount of FWS earnings. Option 3: Credit a specific amount of FWS earnings $ __________ (specify) to my account; and a check for the balance. In signing this acceptance of award, I am accepting the responsibilities summarized above as a Federal Work Study (FWS) student, and I agree to carry out my FWS Assignment to the best of my ability. I understand that I will be expected to perform my duties in a responsible manner and to comply with the requirements of the job and the instructions of my supervisor. I further understand that my employment is contingent upon satisfactory job performance and that I may be removed from my position and from the Federal Work-Study Program if I do not meet minimum standards. I hereby certify, by my signature below, that I have fully read and understand the conditions of this work assignment and contract I agree to its terms. _____________________________________________ Signature ____________________________________________ Name (Print)

____________________________ Date

Acknowledgement Form:

I understand that by virtue of employment with Jarvis Christian College, I may have access to records that contain individually identifiable information, the disclosure of which is prohibited by the Family Educational Rights and Privacy Act of 1974, as Amended (FERPA). I acknowledge that I fully understand that the intentional disclosures by me of this information to any unauthorized person could subject me to criminal and civil penalties imposed by law. I further acknowledge that such willful or unauthorized disclosure also violates Jarvis Christian College policy and could constitute just cause for disciplinary action including termination of my employment regardless of whether criminal or civil penalties are imposed. I have received a copy of the Jarvis Christian College’s Financial Handbook. I have read and understand the procedures and guidelines, and by signing this acknowledgement, I agree to the terms and conditions of my college work-study employment at Jarvis Christian College.

Printed Name:

_________________________________________________

Signature:

_________________________________________________

Date:

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FINANCIAL AID OFFICE P.O. BOX 1470 HAWKINS, TX 75765 (903) 730-4890

APPLICATION FOR COLLEGE WORKSTUDY/JOB PLACEMENT This is an application for College Work-study job placement. It should be completed accurately, using a ball point pen. Do not use a pencil. Please return this form to the Financial Aid Office as soon as possible.

Last Name __________________________ First Name_______________________ MI ____ Social Security #_____/___/_____________

Date of Birth: Mo.____Day____Yr. ______

Classification: ___Freshman ___Sophomore ___Junior ___ Senior Sex: ___Male ___Female Anticipated Major: ___________________________Minor: _____________________________ Permanent Home Address _________________City_____________ State_______ Zip _______ Home Phone # _________________________ Cell Phone # _____________________________ Dormitory ____________________________

Room # ________ Ext # ________

Types of office machines/equipment you operate: Calculator _____________________ Telephone ______________________________ Computer/Printer ____________________ Typewriter ______________________________ Copier _______________________________ Other __________________________________ Fax Machine __________________________ __________________________________ List two campus job preferences: 1. _______________________ 2. ______________________ Academics

Student Activities

Student Affairs

Athletics

Health Services

Filing Clerk

Library

Food Service Office Assistant

Community Service Career Service

List All Previous Work History (JCC Work-study, summer employment, part-time employment)

Employer and address:

______________________________________________________ ______________________________________________________ ______________________________________________________

Dates of Work: From________________ To______________ Nature of Work: _____________________________________________________________________________________ _____________________________________________________________________________________ ________________________________________________________________

______________________________________________________________________________ Employer and address: ______________________________________________________ ______________________________________________________ ______________________________________________________ Dates of Work: From________________ To______________ Nature of Work: _____________________________________________________________________________________ _____________________________________________________________________________________ ________________________________________________________________ ______________________________________________________________________________ Employer and address: ______________________________________________________ ______________________________________________________ ______________________________________________________ Dates of Work: From________________ To______________ Nature of Work: _____________________________________________________________________________________ _____________________________________________________________________________________ ________________________________________________________________ In accordance with College regulations, finalists for any position will be subject to criminal background investigation. I agree I disagree As an Equal Employment Opportunity Employer, Jarvis Christian College is committed to diversity in our faculty, staff and student body.

_______________________________________ ______________________________ Student’s Signature Date All students are required to maintain satisfactory academic progress for continued financial assistance.

2014-2015 WORK-STUDY STUDENT INFORMATION Please print legibly

_______________________________________________________

________________________________

Name

Grade Level

______________________________________________________________________________ JCC Dormitory & Room Number (local address if off-campus) _________________________________________

________________________

JCC Dormitory Phone # (local if off-campus)

Cell Phone #

List Prior JCC Work-Study Department(s): __________________________________________ ______________________________________________________________________________ List Other Previous and/or Volunteer Experience: _____________________________________ ______________________________________________________________________________ ______________________________________________________________________________ List Computer Software Skills: ____________________________________________________ ______________________________________________________________________________ Describe other work related skills:__________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ___________________________________

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Student Signature

Date