Form 10 - Recommendation For Faculty Or Academic Staff Appt

Check only one: FORM 10 ☐ Position: #

RECOMMENDATION FOR FACULTY OR ACADEMIC STAFF APPOINTMENT APPOINTMENT TYPE ☐ FACULTY APPOINTMENT ☐ ACADEMIC STAFF APPOINTMENT ☐ 1-year appointment (Retention review required) ☐ 1-year appointment w/ 1-year budget renewal For all new hires, resume/CV, official transcripts, and a Personnel Appointment Form (PAF). Do not send reference letters with this form. APPOINTMENT DURATION ☐ ACADEMIC YEAR ☐ ANNUAL Begin Date: ☐ SEMESTER ONLY ☐ OTHER Ending Date: NEW/REPLACEMENTS ☐ NEW POSITION ☐ REPLACEMENT POSITION (If replacement, for whom: Click or tap here to enter text.

DEPARTMENT/SCHOOL/UNIT: INTERVIEW DATE: NAME: HOME ADDRESS: CURRENT POSITION/TITLE: OFFICE ADDRESS: HOME TELEPHONE NO.:

ACADEMIC STATUS DEGREE EARNED DATE

DATE OTHER GRADUATE STUDY

TEACHING EXPERIENCE PLACE

ELEMENTARY

SECONDARY

UNIVERSITY

Human Resources and Affirmative Action 2-2-2017 Page 1 of 2 RELATED PROFESSIONAL EXPERIENCE PLACE RANK/TITLE % TIME (Full/Part Time) DATES

TOTAL YEARS: EXPERIENCE TO BE INCLUDED IN LETTER OF APPOINTMENT (Round to nearest half year) ELEMENTARY TEACHING EXPERIENCE SECONDARY TEACHING EXPERIENCE COLLEGE TEACHING EXPERIENCE RELATED PROFESSIONAL EXPERIENCE TOTAL:

POSITION INFORMATION RANK/TITLE: UW SYSTEM CODE (AS ASSIGNED BY HAYES HILL) EDUCATION CODE: PROMOTION SERIES: ☐ Yes ☐ No FULL-TIME BASE SALARY # OF CREDITS (IF APPLICABLE) (PLEASE ATTACH SALARY COMPUTATION FORM) ACTUAL SALARY BASED ON FTE FTE OF APPOINTMENT

TENURE DOES THIS CANDIDATE HAVE THE ☐ Yes ☐ No NUMBER OF YEARS GRANTED MINIMUM DEGREE REQUIRED TO TOWARD TENURE: QUALIFY FOR TENURE? (PLEASE INCLUDE JUSTIFICATION BELOW.) CONTRACT CONTINGENCY (if applicable) REMINDER: GRADUATE COUNCIL APPROVAL IS REQUIRED PRIOR TO AN APPOINTEE TEACHING A GRADUATE COURSE CONDITION: EDUCATION: CODE: RANK: SALARY:

APPROVED, Department Chair/Associate Dean/Unit Supervisor DATE

APPROVED, Dean/Director DATE

APPROVED, Director of Human Resources and Affirmative Action DATE

APPROVED, Chancellor/Vice Chancellor/Assistant Chancellor DATE

FOR HUMAN RESOURCES REVIEW ☐ CHBC RECEIVED FROM JOB ☐ CHBC PROCESSED BUT NO ☐ CHBC PROCESSED WITH ☐ INCLUDE A CHBC APPLICANT RESULTS RESULTS CONTINGENCY IN THE CONTRACT SALARY WITHIN RANGE ☐ YES ☐ NO IF NO, ESR? ☐ YES ☐ NO EDUCATION V. POSTING ☐ YES ☐ NO TITLE CODE/PREFIX ☐ YES ☐ NO PAF (i.e. funding, percentages, ☐ YES ☐ NO SALARY COMPUTATION FORM (if ☐ YES ☐ NO total base salary) applicable)

Human Resources and Affirmative Action 2-2-2017 Page 2 of 2