Temporary Employee
Request Form
Date:
TERF Number:
Department Name:
Dual Credit Location:
Revised
New
Employee ID#:
Recommended Employee Name:
Course/s Title: Course Number Section
Number of Credits
Pay Rate Amount
Total
Contract Type:
End Date:Start Date:
Campus/Location:
Adjunct/Community Education/Supplemental Complete As Applicable:
Hourly Complete As Applicable
Important: All hourly employees will be paid upon submittal of an approved time sheet on a biweekly basis as per
instructions on reverse side of time sheet.
TotalHourly Pay RateNumbers of HoursPosition Title AND Assignment
Specialized Assignments
TotalPay rate:Position Title AND Assignment
NOTE: Provide rationale or justification for the TERF.
Human Resources
Director/Coordinator/
Manager
VP of Academics
VP for Finance and
Administration
President
Account Number:
Revised 12-11-17
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