APPLICATION TO WORK IN COMPUTER SCIENCE MAJORS LAB

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PART A and B of this form must be completed and turned in to RANDOLPH LANGLEY
each semester before your appointment papers can be processed. You must be able to present your social security card at the time of this application. If you wish to work in the lab, complete PART A OF THIS APPLICATION AND GIVE IT TO Mr. Langley IN ROOM 208B MCH.

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PART A I (name)_________________________________ (ss#)______________ am a

Graduate ___, Undergraduate ___ student wishing to work as a Lab Assistant in the lab during the ____________ term 2002. I will be able to work ______ hours each week. I (am currently ___; have ___; have not ___) working/worked for Computer Science/FSU before. (If you are currently working for FSU or have worked in the past please give approximate dates and the department you worked for: ____________________________________________.)

My email address is:_________________________

My phone numbers are: (work)_________________ (home)_________________

Best hours to reach me are: (work)____________ (home)________________

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PART B (TO BE COMPLETED BY Randolph Langley)

I have reviewed the above and approve the following:

Start date:_______________________End date:last day of Exams.

Student Approved For _____ Weekly Hours X 2 = _____ Biweekly Hours.

Hourly Rate: $6.50 or $_____ ___(INITIAL IF PAYING MORE THAN STANDARD $6.50)

This student is a ___ graduate student; ___ undergraduate student,

_________________________ ___________

Randolph Langley         Date

PART C (FOR OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE.)

Start Date:____________ End Date:_____________

Biweekly Hours Working:_______ FTE: ______

Number Pay Periods:______ Hourly Rate: $________

Biweekly Rate: $_________ Period Amount: $___________