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St. Cloud State University
PERSONNEL ACTION PROCESSING FORM
Form Instructions:
* The Chair/Supervisor shall complete the request below, attach required documents, and route for recommendation.
* For all requests except Emeriti Status (full professor), staple the original letter or memo to this form detailing specific
personnel action requested.
- For full professor emeriti: complete the request box below and specify that the10yr. and “good standing”
criteria are met. This form should be routed for recommendation based on these two criteria.
- For not full professor emeriti: attach a nomination letter from the employee’s home department or
administrative area to include information on years of service, distinguished service record, and good standing.
NAME:
DEPARTMENT:
PERSONNEL ACTION REQUESTED: Retirement Phased/AEP Retirement Resignation
Leave of Absence With/Without pay Election of Chairperson Other:
Emeriti Status (full professor) Emeriti Status (not full professor)
Department Chair/Supervisor (signature) Date
Recommend
Not Recommend
Dean/Supervisor (signature) Date
Recommend
Not Recommend
Human Resources (signature) Date
Recommend
Not Recommend
Vice President/Provost (signature) Date
Request Accepted/
Approved
Request Denied
President (signature) Date
After receiving appropriate signatures, the form will be routed to Human Resources for processing. Revised 9/7/16
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