Hours per week:
Regular Schedule
Hours
(Start – End)
Break Length
(min. ½ hr. if applicable)
through
Hours
(Start – End)
Break Length
(min. ½ hr. if applicable)
Mon Tue Wed Thu
Fri
Sat Sun
Mon Tue Wed Thu
Fri
Sat Sun
or
ONGOING
Contract months: 10 11 12
Full-time: Scheduled 5/8 (five 8-hour days)
or 4/10 (four 10-hour days)
OR
Employee Name:
FTE (1.00 is full-time):
Position:
Department:
Acknowledgement of Receipt
The following contractual conditions have been met:
Part-time: Total hours per week equate to
District assigned FTE
The days and hours are consecutive except
for a lunch break that is less than 60 minutes
as requested by the employee.
OR
The days and hours are consecutive except
for a 60-minute uninterrupted lunch break.
No shift differential applicable
OR
Applicable shift differential if assignment is
ONGOING or temporarily more than 5 days and
scheduled 3 or more days past 6:00 pm
scheduled 3 or more days past 7:00 pm
schedueld 3 or more days past 9:00 pm
scheduled past 12:00 am (midnight)
scheduled with a split shift
Campus Police Officer on rotating shift
OR
No reduction from current schedule shift
differential due to temporary nature of
assignment (less than 20 days)
(Employer initiated in accordance with Article 9 of the District/CSEA Agreement)
Employee's Signature
Date
Date
Reviewed by Human Resources
Supervisor's Signature
Date
Date
Signature, CSEA Representative
New Schedule (effective dates):
2/4/2011
Acknowledgement of Receipt
Work Schedule Change Notification
