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2012 Summer Worker Agreement

Please fill in the following information.
Paper copies of this form are available in the Student Employment Office in CTC 307.
First Name: Middle Initial * Last Name: * ID Number: * Phone Number:
* Employing Department(s)
Carefully read each statement below and indicate that you understand and agree.
* If I am living in the dormitory or other university housing, I agree to or have already signed up for one of the following deductions from my paycheck to cover my summer rent, cafeteria and other charges as they occur. Must be a minimum of 60%
If I do not want to have this deduction, I understand I may see a financial counselor to make other payment arrangements.
* I have already signed up for a voluntary payroll deduction.
* My current payroll deduction is
%
Please change my voluntary deduction for the summer to
%
* For the summer only, I agree to have the following percentage of my gross earnings deducted from my paycheck:
(If I do not want to have this deduction, I understand I may see a financial counselor to make other payment arrangements)
%
* I will pay Walla Walla University EACH MONTH for any charges not covered by a payroll deduction.
* If I do not pay my bill on time, a FINANCE CHARGE of one percent (1%) per month will be charged. This is an ANNUAL PERCENTAGE RATE of twelve percent (12%).
* I need to save the balance of my summer earnings for the coming school year.
* I realize if I don’t have savings from my summer earnings for the school year, it may affect my enrollment.
* I will take personal responsibility for honoring this agreement.
* I understand this is not a Summer Bonus Agreement. If I want to participate in the summer bonus program, I must complete the Summer Bonus Agreement by July 1, 2013.
* Walla Walla University’s use of your electronic signature requires your consent. You have the right to have this document provided to you in paper form at no charge. You also have the right to withdraw your consent, to use your electronic signature, by contacting a University representative. Consequences for withdrawing your consent, if any, will be discussed with you when the withdrawal request is received.

By typing in your name and clicking on the "Submit" button below, you are providing electronic consent to use your electronic signature and agree that all information you are providing to Walla Walla University on this document is true, complete and correct to the best of your knowledge.    
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