Conditions of Employment Form

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District Financial Aid Office
11011 SW 104 Street, Room 1125, Miami, FL 33176
Florida Work Experience Program: Phone:(305) 237-0381
Emal: workprogram@mdc.edu

2024-2025 Conditions of Employment

Please fill out this form completely and accurately. Email this form in PDF format to workprogram@mdc.edu

IMPORTANT: YOU MUST CONFIRM STUDENT ELIGIBILITY WITH MIAMI DADE COLLEGE REPRESENTATIVE BEFORE YOU OFFICIALLY HIRE A STUDENT.

Taxpayer Identification Number:

Firm's Name:

Firm's Phone Number:

Firm's Contact Email:

Firm's Address:

City:

State: FL

Zip Code:

Student's Name:

MDConnect Student ID:

Student's Address:

City:

State: FL

Zip Code:

Student's Social Security Number: (only the last 4 digits)

Student's Email:

Job Title:

Hourly Wage:

Effective Hire Date

This Condition of Employment Form is valid from: July 1, 2024 to June 30, 2025

Job Description: Please write in or attach a copy of the approved job description.

NOTE: Please wait to receive confirmation before the student begins work under the FWEP program.

By signing this form you are certifying that all information provided on this form is complete and correct, to the best of your knowledge.

Employer's Representative Signature: ____________________________	Date: _________________________
Employer's Name (Print Name):__________________________	Title:____________________________
Student's Signature: ____________________________________________	Date: _________________________
Institutional Representative Signature: ____________________________	Date: _________________________

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