MIRACOSTACOMMUNITYCOLLEGEDISTRICT
ASSOCIATEFACULTYOFFICEHOURSTIMEREPORT
LASTNAME:________________________FIRST:______________________M.I._______
SEMESTER:FALLSPRING 20____ TOTALASSIGNEDLHE:______
CREDIT NONCREDIT(SELECTONE:NCESL
PAYID:________
DATE OFFICEHOURS TIME
EXAMPLE:WED.10/12 EXAMPLE:5:006:00P.M. EX.:1.0
TOTAL
RATE=$44.00/HR
DEANSOFFICEINITIAL
PAYROLLUSEONLY:ACCOUNT#
O
FFICEHOURSSHALLBEPAIDATTHEFLATRATEOF$44PERHOUR(AFCBA11.4).
I
CERTIFYTHATALLOFTHEINFORMATIONREPORTEDABOVEISCORRECT.IAUTHORIZEMIRACOSTACOMMUNITYCOLLEGETOMAKEANY
NECESSARYADJUSTMENTSDUETOUNDER
/OVERPAYMENTASNEEDED.
______________________________________________ ___________________________________________
F
ACULTYSIGNATURE DATE DEANSSIGNATURE DATE
REV4/6/2020
SENDSIGNEDFORMTOYOURDEANFORAPPROVAL
AHS
NCGen
NC STV)