Rev 05/10/2013
n
PYRL-SubApptForm.pdf
Page 1 of 1
Substitute Appointment
of a Short Duration
Appointment Form
New Appointment
Date:
Corrects Appt Form
Dated:
Name of Substitute
Empl ID (If none, click NEW)
NEW
Department Campus Zip
Dept ID
Substituting for
Does this employee have another
position on campus?
No Yes
If yes,
Dept
Timebase
EMPLOYEE INFORMATION
APPOINTMENT INFORMATION
CMS Position Number
SCO Unit
Begin Date
End Date
Job Code
Range/Grade Hourly Lecture Rate Hourly Lab/Activity Rate
(MM/DD/YYYY)(MM/DD/YYYY)
It is the policy of the California State University, Chico pursuant to the Immigration Reform and Control Act of 1986 to hire only citizens of
the United States and other persons eligible to work in the United States under terms of the Act. Candidates are subject to a criminal
records check. The person holding this position is considered a “mandated reporter” under the California Child Abuse and Neglect
Reporting Act (CANRA) and is required to comply with the requirements set forth in CSU Executive Order 1083 as a condition of
employment. Should you accept this offer, and you are not a current employee of this university, you must present in person proof of
identity and eligibility to work to the Human Resources Service Center (HRSC) within (3) three days of arriving on campus in order to be
placed on the payroll. For details regarding the documentation you must present, please contact the HRSC.
As an employee of the California State University, you are required to complete payroll and personnel documents in the HRSC, Kendall
Hall, Room 220, (530) 898-6771, including the Oath of Allegiance, prior to beginning employment. Failure to do so will prevent
completion of your appointment.
When all documentation is received in the Payroll Office, your pay will be issued by the State Controller's Office within ten (10) business
days. Your substitute pay may be subject to retirement, social security/Medicare tax; and state and federal tax.
The hourly rates above represent full payment for the services and include an allowance for preparation time and grading. The maximum
appointment as a short term substitute is up to 20 consecutive calendar days.
A time sheet must be signed by you and submitted by the Dean's office each pay period as designated by the campus calendar. Please
contact the Dean's office at the end of the month to certify actual days and hours worked.
RECOMMENDATION TO HIRE: I hereby recommend the hiring of the above named person as a faculty member under the terms stated
above.
Dean Signature
Date
AUTHORIZATION TO HIRE: I hereby recommend the hiring of the above named person as a faculty member under the terms stated
above.
Provost / Designee
Date
All binding terms and conditions of this appointment are contained in this written offer and in state regulations, systemwide trustee/
chancellor directives, relevant collective bargaining agreements and CSU, Chico policies and procedures.
Please sign and return to the Dean's office indicating that you have read, understand and accept the conditions of this appointment.
Your early response to this offer is most appreciated. If your response is not received within twelve (12) days of the date of the Dean's
signature, this offer is automatically withdrawn and is void.
I have read, understand and accept the conditions of this appointment.
I do not accept this appointment.
Substitute Faculty Signature Date
