Fillable Printable Employment Verification Letter

Employment Verification Letter

EMPLOYMENT VERIFICATION LETTER

(This is a fillable PDF form)

Student’s Name: _______________________ _____________________ ________

(Family Name) (First) (M. I.)

CUID: _________________________________

TO BE COMPLETED BY EMPLOYER OR HIRING DEPARTMENT:

Employment Department: _____________________________________________

Employment Position Title: _____________________________________________

Employment Start Date: ___ /___ /______ Number of Hours Per Week: _____

Employment Job Nature (Ex. Research Assistant, Library Aid, Wait Staff, Cashier, Academic/Athletic

Scholarships):

________________________________________________________________________________

Employer Address: ____________________ City: _______________ State: ___ Zip: ______

Employer Phone Number: ( ____ ) _________________

Employer Identification Number: 57-6000254

Name of Student’s Immediate Supervisor (Print): ______________________________________

Employer Name (Print): __________________________ Employer Title: __________________

Employer Signature: _____________________________________ Date: ___ / ___ / ______

“My signature above certifies that the above named person is an F-1 student attending Clemson University and that the

student is working or has been offered on-campus employment in accordance with the specifications (Employment

Position, Employment Start Date, Employment Job Nature, etc.) listed above. I further certify that I am the employer or

the authorized member of the hiring department responsible for confirming the student’s current employment at Clemson

University.”

TO BE COMPLETED BY THE DESIGNATED SCHOOL OFFICIAL (DSO):

“This is to certify that the above named person is an F-1 student who is currently enrolled in a full course of study at

Clemson University. My signature below certifies that the student is or has been offered on-campus employment in the

job position listed above and with the Department or Employer listed above and will be performing responsibilities directly

related to the job nature listed above.”

Name of Designated School Official (Print): ____________________________________________________

Signature of Designated School Official: ______________________________________________________

DSO Phone Number (864) 656-3614 Date: ___ / ___ / _____

Rev. 10/07

Print Form