GRADUATE STUDENT WORK EXPERIENCE PROGRAM (GRADSWEP) 2015 - 16 APPLICATION Please use a separate form for each type of position requested and, once completed, return the form(s) to Kyle Hickey, GradSWEP Coordinator, Career Development and Experiential Learning, UC 4002. Memorial Applicant: _______________________________ Unit: __________________________________ Phone: ____________________ Email: _______________________ Community Organization: __________________________ Community Partner: ______________________ Phone: ____________________ Proposal initiated by: Email: _______________________  Memorial Partner External Community Partner Position Title: _________________________________________________________________________ Project Description/Required Duties: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Qualifications/Skills Required (academic specialization, year of study, etc.): ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Hours of Work (9-5, evening, weekend, etc.): ________________________________________________ Funding Request (please check all that apply):  Spring/Summer 2015 # of positions ____ Fall 2015 # of positions ____ Winter 2016 # of positions ____ Please Note: GradSWEP funding is based on the salary cost of $ 21.15 per hour (which includes vacation pay) for 75 hours, but does not cover the cost of other benefits. We acknowledge that the Memorial Unit will ensure that all students hired under this program meet the minimum requirements as set forth, and that the Memorial Unit shall take administrative and supervisory responsibility for the students. ________________________________________ Memorial Applicant __________________________ Date ________________________________________ Dean/Director/Department Head __________________________ Date I acknowledge that my organization will provide 50% of the salary cost (exclusive of benefits) required to fund the proposed position(s), equal to $794 per approved placement. ________________________________________ External Community Partner __________________________ Date For CDEL/SGS Use Only GradSWEP funding approved as follows:  Spring/Summer 2015  Fall 2015  Winter 2016 # of Positions ____ # of Positions ____ # of Positions ____ ________________________________________ CDEL/SGS __________________________ Date Note: GradSWEP funding will be transferred via Journal Entry at the end of the applicable semester(s).