Fillable Outside Employment Form

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Outside Employment Form

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Outside Employment
During the 2016-2017 academic year, I have the opportunity to accept or continue the
following outside employment. I certify that these outside employment activities adhere
to University policy and will not conflict or interfere with my duties as a full-time
member of the Jacksonville University faculty. I acknowledge that it is inappropriate to
use the University resources to support my outside work. (Attach extra pages, as
necessary, to describe the duties of the position(s), time commitment, and contribution to
the University’s mission of teaching, professional development, and public service.)
Name of Full-Time Faculty______________________________________________
Name of the Outside Employer and Briefly Describe the Employment:
Approximate Hours of Activity Per Week:
Approximate Total Days of Activity Per Semester:
I certify that this outside employment does not represent a conflict of interest with
employment at the University, nor will it conflict with the duties and responsibilities of
full-time faculty employment.
Signature of the
Faculty_____________________________________Date:___________________
Recommend Approval
Recommend Against Approval
Dean’s Signature _________________________________Date:______________
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Outside Employment Form

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Completed 14 February 2020

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