OHR 300/Appointment
Revised: 10/06/2015
Prepared by:
State
Affiliated Corporation
Extension: Date:
Type of Appointment Comments
University Support Staff Unclassified Background check completed:
Exempt Non-Exempt Exempt Non-Exempt
New
Re-instatement+
New
Re-employment+
Re-appointment
+for University Support Staff only, must have explanation in Comments.
University Support Staff
Unclassified
Faculty Professional Instruction Length of Appointment
Regular
Temporary
No
9 month
Limited Term Regular
Temporary
Contingent
Less than .5
10 month
Probationary
Provisional
.5 or more
12 month
Tenured
Regular
Term (Other)
Grade/Step:
Executive Annual Base Pay
$
Hourly/Other Amt.
$
Hrly. or Biweekly
$
In what state will this employee primarily work?
In what state will this employee primarily reside?
Employee Information
Name
myWSU ID#
Last First MI
Home Address
Street City State Zip
Campus Address
Building and Room Number Extension Campus Box
Employee’s Supervisor and WSU ID#:
If unclassified 9/10/12 month:
Terminal Degree
From (univ.)
Date Awarded
Prior Yrs. Service
Salary/Funding
Start Date
Stop Date (if unclass.)
Eligible for
Benefits
Shift Diff.
Org. No.
Org. Name
Position No.
Position Title
FTE Proposed Funding Source(s):
GU $
RU $
GU Fund #:
RU Fund #:
Required Signatures:
Budget Review Officer: _____________________________________________________________ Date ____________________
University Budget Director: __________________________________________________________ Date ____________________
President/Vice President: ___________________________________________________________ Date ____________________
BANNER APPROVED FUNDING – UNIV. BUDGET OFFICE ONLY
:FTE: _______ PClass: ________________ EClass: ______________
Fund Organization Account Amount % FTE
Banner Forms Completed: POSN _____ PBUD _____ JOBS _____
Budget Office Distribution: Human Resources – Original, Budget Officer – Canary, Budget Review Officer – Blue,
University Budget Office – Pink, President/Vice President – Tan, Payroll - Lilac
