Fillable UKCOH-Adjunct-Appointment-Form FINAL - Rough Appt Form

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UKCOH-Adjunct-Appointment-Form FINAL - Rough Appt Form

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ADJUNCT APPOINTMENT FORM
SEMESTER (Check One):
FALL SPRING SUMMER YEAR
DEPARTMENT:
REVISION
ADJUNCT NAME:
IS ADJUNCT (Check One):
New * ______________ Returning
* If Adjunct is new please indicate the date the background screening form was submitted to Human Resources
Ms.
Mr.
Instructor Volunteer
Faculty Associate
UWF ID #:
COURSE INFORMATION:
BEGINNING DATE:
ENDING DATE:
COURSE NUMBER &
TITLE
SECTION
NUMBER
CREDIT
HOURS
LOCATION
TAUGHT
AMOUNT
TOTALS:
*If Cross-Listed, Please indicate the section number to the course to which it is cross-listed.
_________________________________ _______________________
DEPARTMENT CHAIR SIGNATURE DATE
FOR UK
COH OFFICE USE O
NLY
OFFER LETTER SENT
_________________________
ACTION SHEET SENT
______________________
CROSS-
LISTING*
Extra State Comp
AP / CE
TLH / CE
TLH non CE
Total FTE ______ Dean's Office Use
Dr.
TITLE (Check One):
RANK (Check One):
HOME ADDRESS:
TELEPHONE:
2018
EMAIL ADDRESS:
0
$ 0.00
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UKCOH-Adjunct-Appointment-Form FINAL - Rough Appt Form

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Completed 17 November 2019

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