Prior Hours Verification Form

You have three options for completing this form:

  1. Download the PDF, print it out, and complete by hand.
  2. Download the PDF, open it in your favorite app to fill out and submit either by printing or emailing.
  3. Complete the form below that upon clicking the button, will fill out the PDF and download it for you so you can print or email the form accordingly.

When requested by the Office of Human Resources at W&L, please fill in your name on this form, hit generate at the bottom of this form and then submit the form to the HR department of your previous employer. Once they have completed the form, please have them fax it to Kim Austin, 540-458-8060.

Employees qualify for university contributions after two years of 1,000 or more hours worked at W&L. If you worked 1,000 or more hours for a college or university just prior to being employed by W&L, then you may have one year toward the waiting period. If you worked 1,000 or more hours for a college or university in the last two consecutive 12 month periods, you may have two years toward the waiting period. If we have indicated we cannot tell from your c.v. whether or not you qualify for university contributions sooner than two years, please have your former employer(s) complete and return this form. If you return the form within 90 days and we determine your eligibility for university contributions upon employment, we will make a contribution retroactive to your first day of employment. If you return the form after 90 days, the university’s contributions will begin the 1st of the month following receipt of this form.

Fax to 540-458-8060 or email to Please call Kim Austin at 540-458-8921 if you have questions.