Professional Staff Teaching Form

Professional Staff Teaching Form NAME:

JOB TITLE:

DEPARTMENT:

SCHOOL:

EMAIL: Professional staff employees who teach classes, must submit this form to Human Resources each semester

I plan to teach students during the Fall/Spring/Summer Semester ______. I recognize that this work is in addition to my other department or school duties, and that I remain responsible for these other duties throughout this period. I understand that if my department accommodates my teaching schedule it is my duty to adjust my schedule to fulfill a regular 40 hour work week.

Please indicate your anticipated schedule adjustment below. If the class is being taught online or after work hours please mark the appropriate box below

DATE: AM PM Planned Online/ Adjustment After Hours Class Monday

Tuesday

Wednesday

Thursday

Friday

NB: The total weekly, work effort should meet the minimum 40-hour weekly expectation. If it does not it could be considered “ghost employment” which is a violation of the Fair Labor Standards Act and therefore, strictly prohibited by Indiana University.

Signed: ______(Employee Name) (Date)

Approved by: ______(Department/Unit Manager) (Date)

This completed form must be attached to the Associate Faculty Contact in order to be processed.