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Northern Illinois University

Career Services

Part-time Placement Reporting Form

This on-line form allows Career Services to document the part-time employment successes of NIU students and alumni. It may be filled out by either student/alum or employer. This information is kept confidential.

If you have any questions, please contact Kathy Zuidema at (815) 753-8344.

All *fields (required information) must be completed for successful form submission.
Gather pertinent information before you begin the application.

Name
* First Name:
* Last Name:
ZID:
Student Job Information
*Job Title:
*Hourly Wage:
*Start Date :
End Date:
*Hours per week:
Employer Information:
*Employer:
(Example: Motorola, Jewel/Osco, etc.)
*Job Location:
* How position was secured:

Check all that apply. If more than one, hold down CTRL key when selecting.