TALLAHASSEE COMMUNITY COLLEGE
AUTHORIZATION FOR OUTSIDE EMPLOYMENT
Must be submitted and approved annually
Employee Name:
Department/Division:
PID#
Title:
Date:
Please tell us about the outside employment you are requesting:
Company Name:
Address:
Supervisor’s Name:
Title:
Phone:
Hire Date:
Days/Hours:
Is this a non-recurring employment request? yes no
Will this employment be for six months or less? yes no
Describe Duties:
Employee Certification:
I certify that I have read pertinent provisions of section 112.313, Florida Statues, and that there is no conflict of interest between my
employment at the College and the outside employment requested above. This outside employment shall not interfere with my work
assignment as a College employee.
I also certify that I shall not claim to be an official College representative in connection with this outside employment, that I shall not utilize
the College name, logo, or other official documents of the College without specific approval of the President and the District Board of
Trustees.
__________________________________ ______________
Employee Signature Date
Supervisor Approval:
I understand the College policy regarding outside employment and my responsibility in approving outside employment for this employee,
including an annual review of the outside employment as part of the employee evaluation/appraisal process.
___________________________________ ______________
Supervisor Signature Date
___________________________________
Second Level Supervisor
Approved Denied Date
___________________________________
Vice President
Approved Denied Date
Human Resource Approval:
___________________________________ ______________
Human Resource Director (or designee) Signature Date
Approved by Board at meeting held on ___________________________. Employees working in additional positions outside
of the College should submit an approval request on an annual basis.
Forward original form to Human Resources.
Revised 02/2020
Approved
Denied
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