Property of RSCCD/Human Resources (do not duplicate) Revised 08/2013
RANCHO SANTIAGO COMMUNITY COLLEGE DISTRICT
HUMAN RESOURCES DEPARTMENT
PROFESSIONAL GROWTH PROGRAM FOR CSEA CLASSIFIED EMPLOYEES
REQUEST FOR SALARY CREDIT FORM
Employee’s Name __________________________________________________________________ Date ____________
Employee ID# ______________________________ Work Extension # ____________________
Job Title ___________________________________________________________________ Full-Time/Part-Time ______
Site ________ Department ___________________________________________________________________________
I completed the following course/seminar and request that the units/hours earned be approved for salary increment. I
understand that a total of 12 units/points must be earned for each increment. I have attached a transcript(s), grade
report, letter of attendance or certificate of completion.
Please note: 1 semester unit = 1 unit/point; 3 quarter units = 2 semester units; 16 Hours = 1 unit/point
Course/Seminar # Course/Seminar Title
General
Units/Hours
Job Related
Units/Hours
Units Measured by ___ Hours ___ Semester ___ Quarter Dates of Course/Seminar _________________________
College/Location ____________________________________________________________________________________
Please provide a brief description of the course/seminar
I understand that District activities are not eligible for credit if the district pays any required fees, and I attend during
scheduled working hours, unless
I use vacation or compensatory time off to attend.
Employee Signature _____________________________________________________________ Date _______________
REVIEWED BY SUPERVISOR/ADMINISTRATOR
I certify that this employee did not attend the above course/seminar during assigned working hours, or had instead
accumulated compensatory time off or requested vacation hours to attend.
Supervisor/Administrator Name ____________________________________________________ Date _____________
Supervisor/Administrator Signature _________________________________________________
