Hampshire College Human Resources Change Form (Faculty)
Please complete ALL data and forward to the Dean of Faculty Office for processing.
This document is confidential and should be treated accordingly.
Employee Data:
Name: __________________________________________________________________________________________________
Last First Middle
Address: _________________________________________________________________________________________________
Street City State Zip
Home Telephone Number: _____________________________ Home E-mail: _______________________________________
Appointment Information: (please check all appropriate boxes)
Change in Salary
Change in General Ledger Number
Split GL Position (requires a form for each position)
Transfer (TR)
Additional Appointment Leave of Absence Promotion/Change in Title Reappointment Course Release FTE Change
Sabbatical Fall Spring Leave of Absence - Fall Spring FMLA- Fall Spring
Start Date or Effective Date: _________________________ End Date: _________________________
(for changes, recording leaves) (record contract end date, end date of leave/sabbatical)
Dean 61101
Professor 61001
Associate Professor 61001
Assistant Professor 61001
Visiting Professor 61004 Visiting Associate Professor 61004 Visiting Assistant Professor 61004 Scholar/Post-Doc - 61009
Adjunct Professor 61006 Adjunct Associate Professor 61006 Adjunct Assistant Professor 61006 Adjunct Instructor61006
Adjunct Examiner 61006 January Term Instructor 61006 Emeritus Professor 61006 Faculty Assoc – 61005 Sr. Faculty Assoc - 61005
Position Title: __________________________________________________________________________________________
Division III Chair Div III Member Division II Chair Div II Member Other________________________________
Salary/Budget Information:
Annual Salary: $________________________ FTE: ___________ TOTAL MONTHS IN EMPLOYMENT CYCLE: ________
Should match Current Salary Should match Current FTE
Funding Source: General Ledger Account Number: 80 0 90 0 ______ ______ ______ ______ ______
Department Fund Name/Grant Name: __________________________________________________________________
Comments: _____________________________________________________________________________________________________________
Faculty Exchange Programif yes, please complete this section: Funding Source: 80 0 _____ _____ _____ _____ ______
Bill to: _______________________________________________________________ Amount: $ _________________________________
Office Information (OFFI):
Building: __________ Office :____________ Ext: ___________ Campus Mail Box: _________ Email: _______________________________
_____________________________________ ______________________________________ ________________________________________
School Dean Date VP for Academic Affairs & Dean of Faculty or Director of Strategic Budgeting & Analysis Date
Associate VP of Academic Affairs Date
For Dean of Faculty Office and Human Resources Only
Dean of Faculty Office Processing: Position Type/FTE/Salary ( if changing used POSS screen)
Regular FTE (for position):________ Regular Salary (PBDS) (for position):_______________
Current FTE (for person in position):________ Current Salary (PWAG) (for person in position):_______________
Budgeted FTE (FTE currently budgeted):________ Budgeted Salary (XPOS/PBDI)(amount currently budgeted):___________
Close Vacated Position? YES NO
Human Resources Processing:
Position ID#_________________________________________________ ________ __________ MP - Pay Cycle
Department Abbreviation Object Code(3 digit) Title Abbreviation Pay Class
XHRS: Medical FTE_____ Benefit Start Date__________ HR PROCESS DATE/INITIAL: _________ Close Vacated Position? Yes
Distribution by HR: Payroll HR/Benefits HR/Personnel File School Office DOF Faculty Change Form 8-2015