DIV/DEPT: IMMEDIATE SUPERVISOR:
n
ACTION REQUESTED
Hire Rehire Stipend
Overload Extra Assignment Termination Other
n
TYPE OF ASSIGNMENT
Academic Classified Administrative Supervisory
Confidential
Other (i.e., Substitutes, Professional Experts, and Short Term Employees)
Full-time Part-time On-going (Regular) Not On-going (Temporary)
n
POSITION INFORMATION (TO BE COMPLETED BY DEPARTMENT)
Worksite location (campus):
End Date:
Hrs/Wk.
TO Hrs/Wk.
10 months 11 months 12 months
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
8 – 4:30 9 – 5:30 8 - 4:30 9 – 5:30 8 – 4:30
To:
Max: Schedule:
Step Rate $
Benefits:
Full Partial None No Change
n SIGNATURES
Director/Dean Date Vice President Date
Comments:
Business Services(Budget Approval) Date Human Resources Date
Comments:
Position: Name:
Board Authorization Date (s)
CWA Union Dues Eligible
PREPARED BY:
Replacement for:
Start Date:
Please provide an explanation for temporary assignments:
Recruitment
MT. SAN JACINTO COMMUNITY COLLEGE DISTRICT
Human Resources Services Request (HRSR)
SEQUENCE NO:
DATE PREPARED:
BUDGET CODE (Mandatory):
Substitute for:
Employee Name:
Daily work schedule REQUIRED (indicate the days and times employee will be scheduled to work):
Classified contract length:
Employee No.:
Complete ONLY if hrs are being changed: FROM
Position Title:
Budget: Level:
Step - From:
STOP! (TO BE COMPLETED BY HUMAN RESOURCES)
Total wkly hrs
Example:
40
Rate – Min:
$
$
Placement: Level
Comments:
Comments:
HR Analyst Initials:
Schedule ID:
Comments:
New Position
HR Distribution: Payroll Benefits Time and Attendance Board Agenda
.
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