☐    Full Time
☐    Part Time
FSLA STATUS:
☐    Exempt
☐    Non-Exempt
SALARY TYPE:
☐    Salaried
☐    Hourly

DEPARTMENTAL USE

Revised Description:

☐ Yes ☐ No

POSITION DETAILS:
Incumbent:
Department:
Position Working Title:
Supervisor (Title):
Time Sheet Approver (Title):
Campus/Site:
JOB SUMMARY ( *Maximum of 2 Sentences* ):

MINIMUM QUALIFICATIONS:
Minimum Education:
Minimum Work Experience:
Preferred Education:
Preferred Work Experience:
Required Licenses or Certifications:
Other Minimum Qualifications:
Preferred Qualifications (if applicable) :
Physical Demands:
Work Week:
FULL JOB DESCRIPTION:

JOB DUTIES: ( As Many as Needed; % MUST = 100% ):
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%	TOTAL JOB DUTIES

Employee signature below constitutes employee's understanding of the requirements, essential functions, and duties of the position.

Employee___________________________________ Date_____________

THIS POSITION HAS BEEN APPROVED FOR GENERAL USE:

Supervisor/Division Dean/Executive Dean Date

Assistant/Associate Vice Chancellor (if applicable) Date

Appropriate Vice Chancellor Date

Vice Chancellor for Academic and Student Affairs Date
(for faculty credential verification only)

Assistant Vice Chancellor for Human Resources Date

ALL SECTIONS MUST BE COMPLETED. FORWARD THIS FORM ALONG WITH ALL SUPPORTING DOCUMENTATION TO HUMAN RESOURCES.

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Form 2200/005 (5/2021)