Asnuntuck Community College Personnel Request Form Date: Board Title or Classification:
Employee Name:
Parenthetical Title: Full-Time: Part-Time:
Reclassification: Increase in Hours: (Hours)
(Proposed Hours)
Justification for Position and Rank:
Bi-Weekly Salary:
Fund: Or hourly rate for part-time
Starting Date:
Ending Date: (Should be start of a payroll period)
Permanent Position:
or Temporary Position:
Supervisor: Attach a revised table of organization and a copy of the job description for a new position.
Dean
Date
Dean of Administration
Date
Director of Personnel
Date
President
Date
Cc:
Dean of Administration Dean President
PER1 – 12/96
