Personnel Action Request & Notice of Employment HR Only

Position Approval Request & Notice of Employment (PAR/NE) The following terms and conditions are subject to approval by Board of Trustees Instructions: Complete items (1) through (8) and submit to the appropriate administrators and cabinet for approval. New employees are not authorized to begin employment until approved by Board of Trustees action. Employees must attend human resources’ orientation during the first week of employment. 1) Check all that apply:

New Management Stipend Substitute No benefits 10 Over 12 Replacement Supervisory Categorical Short Term 9 months 12 Months Change Confidential Part-time Prof Expert 10 Months 11 Over 12 Faculty Classified Full-time Regular 11 Months 2) Please Type or Print: (Last, First, Middle Initial) Name (If known): Address: City/State/Zip: Phone No: 3) Recruitment Requested: Yes No Replacement For: 4) Starting Date: Ending Date: (End date cannot extend beyond end of current fiscal year for temporary empls.) 5) Position Title/Job Code: 6) Work Schedule (days and hours). Attach FY worksheet if applicable. Contract Max Wkly Max (Cannot exceed 999 hours/170 days for temp. employees. Days: Hrs: Days: Supervisor must monitor.) 7) Assignment Details: Location Dept. Supervisor Telephone Ext Budget-Object - % - % - % Code & Cost Estimate: - % - % Sal/Hrly Rate(s): $ 8) Rationale:

9) Budget Analyst Only: Funds are available. Funds are not available. Budget transfer attached. and/ 10)Position Request Approval: or Administrator/Dean Date Cabinet Officer Date Position Request Approval: VP Admin Services or Date Date Designee Superintendent/President Approval of position does not imply authorization to hire specific individual unless name is listed in #2 above. Do not write below this line. For HR and Payroll use only. Payroll department use only Job BOTA PARNE JOB N/A OA: Code: : #: #: Position Title: Salar Sal Column/Range/St y: Schedule: ep: Annually Monthly Hourly Stipend : Overload Rate- Column/Step:

Revised 4/8/2018 Time sheet must be submitted to Payroll Department by the 11th of each month. Maximum allotted Maximum allotted Supervisor must hours days monitor. Separation: Voluntary Involuntary (End of Need) Reason Effective Date: : PARS PERS STRS (Defined Benefit STRS (Cash Balance Plan) Plan)

HR Dat Approval: e: Distributi Human Supervisor/ Payroll on: Resources Administrator Budget Employe (Date) Analyst e ______

Revised 4/8/2018