Person has taught for SAU before No Number of Years
Date of Request
Department/School Charge to Account No.
Information about the teacher:
Teacher’s Name & ID #
Highest Degree
Person has taught this class before *No Yes
If this person has not taught the class before, the faculty qualification form must be filled out, and approval must be
obtained from the Associate VP for Academic Administration prior to the beginning of the class.
Time period of request:
Fall Semester (or) Winter Semester
Academic Year Academic Year
(or) Summer Session: 1 2 3
Full Summer Semester
(or) If not a full semester or summer session, give exact dates:
) to be taught:
Course No. Course Title Credit Hours
Course No. Course Title Credit Hours
Course No. Course Title Credit Hours
Total Credit Hours
Total Remu
Form sent to Human Resources from Academic Admininstration
Qualifications Checked by Associate VP for
Academic Administration to Teach above Course(s)
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Conditions of Employment
1. If for any reason you are unable to fully complete the assignment, compensation will be
adjusted on a proportional basis based on contract hours.
2. A current resume and an official transcript of your undergraduate and graduate credits will be
submitted—if not already on file—to the Vice President for Academic Administration.
3. Adjunct instructors are neither voting members of the faculty, nor are they eligible for
staff benefits.
4. All members of the teaching faculty are under obligation to become familiar with and abide
by the general administrative practices and requirements of the university as found in the
Adjunct Faculty Handbook, Faculty Handbook, and the University Catalog. It is also
important for teaching faculty to be familiar with regulations relating to student behavior as
found in the Student Handbook. These and other pertinent publications of the university can
be obtained from the department chair/school dean.
5. Earnings will be paid according to the institutional payment schedule in the form of direct
deposit to the employee’s choice of banking institution. The “Direct Deposit of Payroll”
form must be filled out and submitted to Human Resources.
6. The university will schedule payment of earnings after all required documents are in your
employee file.
Department Chair/School Dean (sign)
Adjunct Signature
Vice President for Academic Administration (sign)
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