NINE-MONTH FULL-TIME FACULTY
SUMMER SERVICE EMPLOYMENT FORM
1. Employee’s Name:
2. Effective Dates: From: To:
4. Percentage of Time Employed:
5. Rank (or Title): Division:
6. Campus:
7. Summer Salary:
8. Signatures:

AREA 1 AREA 2 AREA 3

Org. Code(s)

Campus Code

Position No.(s)

NINE-MONTH FULL-TIME FACULTY

SUMMER SERVICE EMPLOYMENT FORM

Employee’s Name:

Banner ID #: Last 4 digits of SS #:

Effective Dates: From:                                        To:



Percentage of Time Employed:

Rank (or Title): Division:

Campus:

Summer Salary:

COURSE ACC+OFF
PREFIX DESCRIPTION                                                LCTCS FTE DCC FTE HR/WK HRS PAY HRS DAY NO. WKS AMOUNT

AREA 1

AREA 1

AREA 1

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Compensation for this summer employment will be provided upon validation of minimum student enrollment. If course sections are canceled, the faculty member will be paid for the time worked at the Current Summer Session Pay Scale’s contract hourly rate for instruction or at the current contract hourly rate for non-instructional activities (registration) as applicable.

Signatures:


_________________________________________________________ _______________
Faculty Member            Date

_________________________________________________________ ________________
Division Dean            Date

___________________________________________________________ _________________
Assistant Vice Chancellor for Human Resources Date

Form 2123/001 (4/15)

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	COURSE ACC+OFF
	PREFIX DESCRIPTION LCTCS FTE DCC FTE HR/WK HRS PAY HRS DAY NO. WKS AMOUNT