Fillable REQUEST FOR PERSONNEL ACTION (Southern West Virginia Community and Technical College)

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REQUEST FOR PERSONNEL ACTION (Southern West Virginia Community and Technical College)

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REQUEST FOR PERSONNEL ACTION
SECTION I
NOTE: S
UPERVISORS
- C
OMPLETE
S
ECTION
I,
AND FORWARD TO THE
HUMAN RESOURCES UNIT.
(All screening committee documentation and applications must accompany this request to HR.)
Nominee Name Social Security Number
Street Address
Home Cell
Phone Phone
City, State, Zip
Work
Phone
Ext
Position (Title/Rank):
Classified
Non-Classified
Term Faculty
Minimum Salary
Pay Grade:
Annual:
Monthly:
$
Hourly:
$$
Director of Human Resources: Date:
Immediate Supervisor: Date:
Next Line Supervisor: Date:
Next Line Supervisor: Date:
SECTION II
HUMAN RESOURCES/AFFIRMATIVE ACTION APPROVAL:
Vice President of Unit: Date:
REQUIRED SIGNATURES:
BUDGET APPROVAL:
VP Finance: Date:
PRESIDENT OR DESIGNEE APPROVAL:
President or Designee: Date:
Account Number:
Position Number:
Regular Full-Time
Annual Dates of
Appointment:
Beginning:
Ending:
Full-Time
(Less Than 12 Months)
Number of Months:
Grant Funded
(Important)
Name of Grant:
Temporary
Hours per day:
Days per week:
Weeks per year:
Start Date:
End Date:
(Max. allowable hours 1039 per year)
Start Date: Recommended Salary:
(Classified Staff-See Series 8 if above entry)
Campus:
FTE:
Print Form
HUMAN RESOURCES USE ONLY
SECTION II – JOB OFFER
Job Offer by: ____________________________________________ ___________________________
Signature Date
Date Accepted: __________________________________ Time Accepted: _________________
Comments: ___________________________________________________________________________
Date Declined: __________________________________ Time Declined: _________________
Reason for Declining: ___________________________________________________________________
Other Comments: ______________________________________________________________________
SECTION II – WV 11 PROCESSING
Job Code: ____________________________ Annual Budgeted FTE’s ____________________
Position Number: _____________________ Effective Date: ____________________________
WV – 11 Ref #: _______________________ Fund Account #: __________________________
Personnel File Needed Temporary File Needed
WV-11 Processed by: ________________________________________ ___________________________
Signature Date
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REQUEST FOR PERSONNEL ACTION (Southern West Virginia Community and Technical College)

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Completed 27 July 2020

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