REQUEST FOR APPROVAL OF PART-TIME FACULTY ASSIGNMENT
The following information is to be completed by the Classified employee who is offered a part-time faculty
assignment.
NAME OF EMPLOYEE REQUESTING APPROVAL: _______________________________________
BANNER I.D.: _______________________ CURRENT FTE OF EMPLOYEE: __________________
DEPARTMENT (FOR FACULTY ASSIGNMENT): _________________________________________
SEMESTER: ____________________________________________________________________
Estimated additional amount of time per week to the Classified employee due to faculty assignment
(for lecture/lab classes, list lecture and lab on separate rows)
ASSIGNMENT
ASSIGNMENT
HOURS
ADDITION –FULL
FULL SEMESTER
MULTIPLIER
(18)
**Estimate is based on 1 week of a full-semester length course – multiply x 18/Semester; actual calculations may vary,
depending on length of course.
Note: This preauthorization is effective Semester/Year, and must be completed by all Classified employees who
are requesting to teach in addition to their regular assignments regardless of their current FTE.**
I, _____________________________, am requesting approval to accept the offer of the part-time faculty
assignment as stated above. I understand the following:
• Classified employees who are approved to accept a faculty assignment shall not conduct any work related
to faculty assignment during their classified position work schedule. Office hours for faculty assignment
may not be held during the required lunch hour for classified position.
• There may be PERS and STRS implications of any reduction in time worked and additional assignments (for
example, PERS service credit may be reduced).
EMPLOYEE SIGNATURE _____________________________________________________ DATE ________________
SUPERVISING ADMINISTRATOR APPROVAL _____________________________________ DATE ________________
CCCUE APPROVAL _________________________________________________________ DATE ________________
AS/VP ACADEMIC AFFAIRS APPROVAL _________________________________________ DATE ________________
ADDITIONAL COMMENTS:
_____________________________________________________________________________________________
PLEASE RETURN COMPLETED FORM TO HUMAN RESOURCES FOR PROCESSING PRIOR TO THE START OF THE
ASSIGNMENT.
