DIRECTIONS FOR COMPLETING FORM L-1347

PERSONNEL ACTION FORM FOR
ACADEMIC STAFF/ADMINISTRATIVE POSITIONS

(Revised 7/00)

PERSONNEL ACTION FORM   (BACK OF THE "PINK SHEET")                                                        

E-Mail approval must be received from the provost/vice chancellor (or chancellor), the assistant to the chancellor for affirmative action & diversity, and budget planning & control before an offer of employment is extended and the Personnel Action Form is completed.  The Personnel Action Form is completed by the dean/division officer or designee (such as the department chairperson/unit director).  It is the dean or division officer's responsibility to ensure that all forms and entries are correct.   The PCN (from front side of pink sheet) will be completed by Budget Planning & Control.      

SECTION 6.  ACADEMIC HIRING/APPOINTMENT INFORMATION:  This section should be completed in consultation with the Office of Human Resources.

      Recruitment Number—This number should match the Recruitment Number from the front of this form.

Indicate if the position is:

New (a new hire)

Successor (a reappointment)

Post Retirement (a retired staff member who will now be employed in a post-retirement position)

Interim/Acting (temporary position)

Limited (those who serve at the pleasure of the chancellor as the appointing authority per UWS statutes): Indicate the concurrent or backup appointment department, the concurrent DDU and the concurrent title.  All director titles (assistant, associate or no prefix) are limited.  (If the administrative position will have a Faculty backup, e.g., dean, assistant professor, etc., complete this information.)

Change in Title/percentage--of current employee under contract, complete only name, SS#, Title, Title Code and FTE %.

Account Change--of a current employee under contract, complete only name, SS#, and funding information.

Salary Change--of a current employee under contract, complete only, name, SS#, salary, salary basis and funding information

Other--Any changes not listed above.

Name of the Applicant--as shown on social security card.  Include middle initial.

S.S.#--social security number from Social Security Card.

Phone Number and Mailing Address--this is the address where the employment contract will be sent.

Campus Address/Phone—needed for correct campus location for on-campus mailings.

Sex--indicate appropriate gender.

Education--indicate highest educational level attained.  If the appointee has a doctorate, please enter the month and year it was earned, as evidenced by official transcripts. 

Appointment Length-- Fixed Term (contract for a fixed period which carries no expectation of employment beyond the stated term).  Specify the length of the employment period, e.g., 1 year.  Fixed Term Rolling (only if reappointment) (contract in which an annual renewal decision is made for the future, e.g., a 3-year rolling contract is reviewed annually for renewal or nonrenewal, with 2 years left on the contract).  Specify the length of the contract period (2 or 3 years).

Actual Employment Dates--indicate the actual starting date (day contract begins) and ending date (day contract ends), normally by marking the box corresponding to the correct appointment dates.

Title--indicate official title for the position from the HR section on the front of the form; this title corresponds to the Title Code.

Title Code--indicate the 6-character title code from the front of the form (Section 5).

% FTE--indicate full time equivalency (e.g., 75%).

Working Title--indicate a working title for position, if applicable.

Actual Salary--indicate actual salary the employee is to receive (NOT full-time salary).  Contact HR with questions.

Salary Basis--indicate the salary basis.  If Other, please list specific information.

Fund, IBAC, 1st DDU, %--indicate the full account code where the salary and fringe benefits should be charged.  Also, indicate the percent of salary to be charged to this account.  Under normal circumstances, this account should be the same as on the front side of the pink form.

Fund, IBAC, 2nd DDU, %-- indicate second account code if salary is to be split between different accounts.

Department--indicate the name of the department or office, such as Math or Career Services.

College/Operational Area--For instructional academic staff, this is usually the department the position is in, e.g., Accounting, Curriculum & Instruction; For non-instructional academic staff, the operational area is typically defined as the division or functional equivalent within which they will be employed, such as the Executive Division, the Student Development & Academic Services Division, or the College of Liberal Studies.

SECTION 7-8.  SIGNATURES:

Dean/Division Officer--Signature of the dean/division officer indicates offer of employment has been approved, in consultation with Provost/Vice Chancellor (or Chancellor), the Assistant to the Chancellor for Affirmative Action & Diversity, and Budget Planning & Control after which an offer of employment is extended and verbally accepted. 

The dean/division officer will forward the completed Personnel Action Form (along with official transcripts and a resume of the new hire) to Budget Planning & Control who forwards it to the Provost/Vice Chancellor (or Chancellor) for signature. 

The completed form will be reviewed for consistency by the Office of Human Resources and a contract prepared from the information provided.

For Human Resources Use Only:

Appointment Is Subject to The Advance Approval of The Board of Regents or the President --The title of chancellor requires advance approval of the Board of Regents; vice chancellor requires advance approval of the system president and the Board of Regents; the titles of dean, associate chancellor, associate vice chancellor, assistant chancellor and assistant vice chancellor require advance approval of the system president prior to recruitment and hiring.

Aca Staff Appt Length--applies only to academic staff positions, see details following:

Aca Staff Continuity Status--applies only to academic staff positions, see details following:

Aca Staff Category--applies only to academic staff positions, see details following:

Appointment Length Definition

1                                  1 year  

2                                  2 years

3                                  3 years

4                                  4 years

5                                  5 years

6                                  6 months or ˝ academic year

Continuity Status                 Definition

2                                  Fixed Term, terminal contract     

3                                  Fixed Term, renewal intended

6                                  Rolling horizon; guaranteed length of time based on annual reappoint­ment

8                                  Rolling horizon, termination at horizon; incumbent has been notified that this rolling horizon appointment will be terminated at the horizon date

Academic Staff Category     Definition        

A01                              CAT-A Indefinite                                                

A02                              CAT-A Probationary

A03                              CAT-A Fixed Term

A04                              CAT-A Fixed Term Rolling

B01                              CAT-B Fixed Term Lecturer/Associate Lecturer

B02                              CAT-B Fixed Term Rolling Lecturer

B03                              CAT-B Fixed Term Miscellaneous Instructional Support

B04                              CAT-B Fixed Term Rolling Miscellaneous Instructional Support

B05                              CAT-B Fixed Term Research

B06                              CAT-B Fixed Term Rolling Research

B07                              CAT-B Probationary

B08                              CAT-B Indefinite

B09                              CAT-B Faculty Visiting

B10                              CAT-B Faculty Adjunct

B11                              CAT-B Faculty Clinical

B12                              CAT-B Faculty Emeritus

C01                              CAT-C Fixed Term Coaches

C02                              CAT-C Fixed Term Rolling Coaches

C03                              CAT-C Miscellaneous