Library Student Worker Salary Request

This form should be completed to request an increase in salary for a student worker.

Only one salary increase allowed per year
Standard salary increments are .25 cents per year
Must have approval of Director and University Librarian
Subject to available funds

Student's Name Student's Name First Last
Employment Start Date: Employment Start Date: / MM / DD YYYY
Department
Current Hourly Salary: $ Dollars . Cents
Date of Last Salary Increase: Date of Last Salary Increase: / MM / DD YYYY
Person submitting request Person submitting request First Last
Your Supervisor's email:
Attach last evaluation:

Attach Files

Please choose Yes or No
Please choose Yes or No	Yes	No
This student worker has been employed for 2 or more long semesters	This student worker has been employed for 2 or more long semestersYes	This student worker has been employed for 2 or more long semestersNo
This student worker received a "3" or better average in their last 2 evaluations	This student worker received a "3" or better average in their last 2 evaluationsYes	This student worker received a "3" or better average in their last 2 evaluationsNo
This student worker has no outstanding disciplinary actions currently being addressed or of concern	This student worker has no outstanding disciplinary actions currently being addressed or of concernYes	This student worker has no outstanding disciplinary actions currently being addressed or of concernNo

If applicable, list the student's other supervisors and indicate whether they agree with request
Additional Comments/Justifications: