Request for Additional/ Change of Assignment (Instructional Aide) – July 2015
Pasadena Area City College District
Office of Human Resources
REQUEST FOR ADDITIONAL / CHANGE OF ASSIGNMENT (INSTRUCTIONAL AIDE)
IMPORTANT: This form should ONLY be used to change or add an assignment for a current Instructional Aide. If there
is a break in service or a classification change (example: not worked for a semester or employee is switching from Student Worker
or College Assistant to Instructional Aide),
a new Request for New Employment of an Instructional Aide Form needs to be
completed. If you are unsure, please contact the Human Resources Office for assistance at (626) 585-7388.
_________________________________________ _________________________________________
Employee
(Last Name, First) Social Security #
_________________________________________ _________________________________________
Employee Telephone # Employee Email Address
Contact Person_____________________________Ext.___________ Department________________________________
ADDITIONAL ASSIGNMENT
Add Assignment(s)
___________ 2410 ______________ ________________ EMP#:___________________
___________ 2410 ______________ ________________ EMP#:___________________
Working Title: _______________________ Pay Rate: ________________ Effective Date: _______________
Will this additional assignment result in the employee working over an average of 30 hours per week (Note: Combine
hours for all assignments worked, if applicable)? Yes _____ No ______
CHANGE OF ASSIGNMENT
From: _________2410 __________ ___________To:__________2312 __________ __________EMP#:____________
CHANGE OF PAY RATE
Working Title: From: ________________________ To: ______________________
Pay Rate: From: ________________________ To: ______________________
Effective Date: _________________________
Will this change of assignment result in the employee working over an average of 30 hours per week (Note: Combine
hours for all assignments worked, if applicable)? Yes _____ No ______
PLEASE NOTE: Employees cannot start employment until the Human Resources Office approves their assignment.
HR will send an email approval to the Cost Center manager indicating the effective date.
By signing this document, I certify that I have adequate funding in my budget to accommodate this expenditure
(including any employer mandated costs (FICA, paid sick leave, etc.)
Cost Center Manager’s Name __________________________ Signature _____________________ Date ______________
TO BE COMPLETED BY FISCAL SERVICES
_________________________________________________ __________________ _________________________
Position Control # Job Class # Work Location #
_________________________________________________ __________________ _________________________
Budget Approval Date Budget Reference #
TO BE COMPLETED BY HUMAN RESOURCES
_____________________________________ __________________ ________________________
Human Resources Supervisor Signature Date Authorized Start Date
