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NORTHWESTERN CONNECTICUT COMMUNITY COLLEGE RECOMMENDATION TO APPOINT EDUCATIONAL (Northwestern Connecticut Community College)

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NORTHWESTERN CONNECTICUT COMMUNITY COLLEGE
RECOMMENDATION TO APPOINT
EDUCATIONAL ASSISTANT / NON-CREDIT LECTURER
*Employee is not authorized to begin work until all authorizations are obtained and required documentation is received and verified by Human Resources *
PLEASE CHECK:
EA NCL FALL 20_____ SPRING 20______ Summer 20_____
NEW EMPLOYEE CURRENTLY EMPLOYED BY NCCC # HOURS________________
RETURNING EMPLOYEE CURRENTLY EMPLOYED BY ANOTHER STATE AGENCY
ADJUST CURRENT CONTRACT Name of Agency:_______________________________________
RETIRED FROM STATE SERVICE PREVIOUSLY EMPLOYED BY ANOTHER STATE AGENCY
CANCEL CONTRACT Name of Agency & Dates of Service:______________________________
Justification:
____________________________________________________________________________________________________________
BOR Approved Degree requirement for Position: Associates Bachelors Masters
Cell Phone: _
_______________________
Home Phone: ________________________
Email:_______________________________
EMPLOYEE INFORMATION:
Name:________________________________________________________
Address:_____________________________________________________
City/State/Zip:______________________________________________
______________________________
DEPA
RTMENT:__________________________________ POSITION TITLE:_________________________________________
STARTING DATE OF APPOINTMENT:___________________________ ENDING DATE:_____________________________
# HOURS PER WEEK:___________________ # Weeks:______________________Hourly Rate of Pay: $_____________________
NCL: CRN #______________ COURSE #_______________SECTION/NAME:______________________________________
CONTACT/CREDIT HOURS:______________ROOM LOCATION:________________Days/Time:__________________________
FUNDING SOURCE: OPERATING FUND_____________________________________
GRANT FUND and NAME:_______________________________
TOTAL COMPENSATION: $_________________________________
………………………………………………………………………………………………………………………………………………
REQUIRED APPROVALS:
…………………………………..
For Business Office Use Only:
PCN:_____________________
Signature:__________________
____________________________________________
Requesting Supervisor
____________________________________________
Approving Dean
___________________________________________
Director of Human Resources or Designee
____________
______
_____
Date
_______________________
Date
______________________
Date
……………………………………
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NORTHWESTERN CONNECTICUT COMMUNITY COLLEGE RECOMMENDATION TO APPOINT EDUCATIONAL (Northwestern Connecticut Community College)

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Completed 7 September 2020

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