Scotland coUntY ScHoolS
EMPloYEE actIon FoRM
(03/2<((,1)250$7,21
Employee Status: Full Time Permanent Full Time Temporary Part Time Permanent Part Time Temporary
Months Employed: 12 11 1
 Other _________
Employee
Name:
Location:
Assignment:BBBBBBBBBB*UDGHBBBBB6XEMHFWBBBBBBBBBBBBB
Certified Classified 5HWLULQJ5HVLJQLQJ7HUPLQDWHG7HPSRUDU\3RVLWLRQ7HPSRUDU\&RQWUDFW(QGHG

Replacing:
Ending
Date:
Principal/Supervisor+5SignatuUH
Date
5()(5(1&(6:
Name: __________________________ Position: _____________________________ Phone #:______________
Name: __________________________ Position: _____________________________ Phone #:______________
(03/2<((75$16)(5PLMPLOYEE TRANSFER:EMPLOYEE TRANSFER:
From: ___________________________ To: ____________________________
Replacing:
Classified Certified
HR USE onlY:
+586(21/<


Criminal
Background
Check
completed?
Yes
No Date
Completed:
Drug
Screening
Completed?
Yes
No
Date
Received:
Salary Grade:_________ Step:_______
Is Employee )XOO\&HUWLILHG? ___Yes ___No
(PSOR\HHStatus: %HJLQQLQJ7HDFKHUBBBBB%HJLQQLQJ7HDFKHUBBBBB%HJLQQLQJ7HDFKHUBBBBB
(

/DVW)RXURI66BBBBBBBBBBBRU(PSOR\HH,'BBBBBBBBBBBB
Employee Start Date:
Comments: ________________________________________________________________________________________________________________________________
Health Benefits:YesBBBBB NoBBBBB

_______________________________________
_____________________________________________BBBBBBB
Date
______________________________
([HFXWLYH'LUHFWRU$GPLQ$VVW of Human Resources Signature
Residency 1 _____ Residency 2 _____ Residency 3 _____
Emergency Permit _____ Permit To Teach _____
HR Dept
Other
: ____________________________ (Reason)
click to sign
signature
click to edit
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome