CENTRAL OREGON COMMUNITY COLLEGE
Bend, OR 97701
N O T I C E OF A P P O I N T M E N T
Special Assignment
COCC ID #
Date:
Name:
Phone:
Mailing Address:
Position Title:
Location:
Budget Area:
Duties:
Employment Dates:
Grant Funded Yes No
Budget Line Item #:
Amount in Budget: $
COMPENSATION INFORMATION
Annualized Salary (12 months):
Annualized Salary was determined from: Administrative Salary Schedule Level:
Faculty Salary Schedule Level/Step
Classified Salary Grade
Percent of FTE:
Other (Explain)
Number of full months to be worked:
Number of days to be worked in partial months:
Monthly Rate (Annualized salary divided by 12):
Hourly Rate (Annualized salary divided by 2,080):
Daily Rate (Hourly times 8):
Salary for Appointment Period:
<FTE % X (Monthly Rate X whole Months Worked Plus Days in Partial Months X Daily Rate)>
Benefits: No Yes (If Yes, explain)
PERS INFORMATION
Employee: Please check the appropriate statement(s) regarding member in the Oregon Public
Employees Retirement System (PERS): I am currently a PERS member.
I am NOT currently a PERS member.
I have been a PERS member in the past.
Office Use Only:
Beginning Date
First Pay Date
Mid Mo/End Mo
No. Times Pay
Workers’ Comp Code: 8868
Account Number
Total Amount
Distribution: Signed original to Payroll;
Copy to Human Resources
.
Approved by:
Budget Administrator:
Vice President
Employee
