Fillable Application-for-Salary-Class-Change - SALARY CLASS CHANGE FORM

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Application-for-Salary-Class-Change - SALARY CLASS CHANGE FORM

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HUMAN RESOURCES
PASADENA CITY COLLEGE
Pasadena Area Community College District
APPLICATION FOR SALARY CLASS CHANGE
NAME__________________________________________EXTENSION #_________DATE_______
DIVISION________________________________
CHANGE REQUESTED FROM CLASS___________TO CLASS___________
Please complete the reverse side of this application, listing academic courses and/or equivalent
experiences to be considered for a change of salary classification.
PLEASE DO NOT WRITE BELOW THIS LINE
ACTION TAKEN BY HUMAN RESOURCES
ACADEMIC EQUIVALENT CREDIT
Units Name of
degree
Work
Experience
Travel Professional
Service
Subtotal
Equivalent
Credit
Total
Units
Granted
Previously
Granted
Units
Class Change
Units
Granted
Totals
TOTAL UNITS: ____________ AS OF (DATE): _____________________
Signature______________________________________ Date:________________
Human Resources Technician
Signature______________________________________ Date:________________
Vice President, Human Resources
I. Academic courses completed since last salary class placement, SUBJECT TO
VERIFICATION FROM OFFICIAL TRANSCRIPTS. (Course work previously taken may
not be repeated for credit.)
Name of Institution Course
Number
Course Title Date
Completed
Unit Value
Quarter Semester
II. Equivalent credit MUST BE VERIFIED BY WRITTEN STATEMENT FROM EMPLOYER,
WRITTEN REPORT OF TRAVEL, AND OTHER DOCUMENTATION ACCEPTABLE TO
HUMAN RESOURCES. Specify nature of activity, inclusive dates involved, and
relationship of activity to improved educational service. (Attach supplementary
sheet, in duplicate, for additional information.) ONLY NINE (9) UNITS OF
EQUIVALENT CREDIT CAN BE USED AT ANY ONE TIME TO MOVE FROM ONE
SALARY CLASS TO ANOTHER.
1. Related work experience (maximum 6 units)
__________________________________________________ ________
Units
2. Travel (maximum 6 units)
__________________________________________________ ________
Units
3. Professional service/non-academic course work (maximum 6 units)
__________________________________________________ ________
Units
III. NEW academic degree received (to be verified by official transcripts)
Degree_____________ Institution________________________ Date received_________
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Application-for-Salary-Class-Change - SALARY CLASS CHANGE FORM

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Completed 7 February 2020

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