JACKSONVILLE UNIVERSITY
DISCLOSURE OF OUTSIDE EMPLOYMENT
During the 2018-2019 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______________________________________________
I do not have outside employment
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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