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The Special Education Work-Study Application
Student Name Street Address City State ZIP SSN Date of Employment Please Select... Yes No Reappointment Student Hours Please Select... 0-12 Hours 0-24 Hours BOCES Wk-St Summer School Student No Job Coach Hours per IEP Job Coach Hours Per IEP Please Select... $1.75 $1.75 (2 for 1) $2.35 Hourly Rate Please Select... 07-08 08-09 09-10 10-11 11-12 School Year Please Select... 2008 2009 2010 2011 2012 Summer School Year Teacher School Building
Student Name Street Address City State ZIP SSN
Date of Employment Please Select... Yes No Reappointment Student Hours Please Select... 0-12 Hours 0-24 Hours BOCES Wk-St Summer School Student No Job Coach Hours per IEP Job Coach Hours Per IEP Please Select... $1.75 $1.75 (2 for 1) $2.35 Hourly Rate Please Select... 07-08 08-09 09-10 10-11 11-12 School Year Please Select... 2008 2009 2010 2011 2012 Summer School Year
Teacher School Building