A. B.
Signature: Fall credit hours
(year)
Dept:
(year)
(year)
(year)
(year)
credit hours
Spring credit hours
Summer III credit hours
credit hours
INSTRUCTIONS FOR COMPLETING FORM: Applicant should complete all pertinent information and
obtain funding information before forwarding to the Department Chair, who will then forward to the
dean's office. The dean's office will submit a list of all AWA assignments to the Provost and President
for approval each semester.
Name:
Indicate workload equivalency in credit hour for
each semester:
Summer I
Summer II
Green Green Green Green Green Green Green Green Green Green Green Green Green Green Green Green
West Chester University of Pennsylvania
Alternate Workload Assignment
C. Replacement Necessary?
Please indicate funding source (e.g. Dept/Dean/External Source):
SAP Cost Center:
D.
E.
Dean
Yes No
(Use the second page of this form for additional comments)
Tasks to be accomplished:
Recommend: Yes No
Date
Yes
Signature:
This section should be completed for non-contractual alternate work assignments only.
Assignment: Title:
No
Org Manager's Name:
Department Chair Date
Rev. 06/08
