Connecticut State Colleges and Universities

Connecticut State Colleges and Universities

Asnuntuck Community College

ComplianceFormfor

ReportingofResearchorConsultingwithOutsidePublicorPrivateEntity

Procedure:

1.ThisformmustbesubmittedbyfacultymembersforreviewbythePresident,ordesignee and the Dean of Academic Affairs,priortoengaginginanyoutsideconsultingorresearchthatinvolvescompensation,inaccordancewithBORpolicyapproved11/21/13.

2.Acopyofthisformindicatingwhethertheoutsideactivityis“incompliance”or“notincompliance”shallbereturnedtothefacultymember.Anappealprocessiscontainedonpage2ofthisform.

3.Acopyofthisformshallbeplacedinthefacultymember’spersonnelfile.

4.For further information, see Procedure for Reporting of Research or Consulting with Outside Public or Private Entity.

Name: ______

AcademicRank Discipline: ______Department: ______

DescriptionofConsultingServiceorResearchProject(attachadditionalpagesifneeded):

______

______

______

Pursuanttothe2011GuidetotheCodeofEthicsforPublicOfficialsandStateEmployees,stateemployees“maynotutilizestatetime,materialsorpersonnelincompletingtasksforoutsideemployment”.

Name of Public/Private Entity: ______

DatesofEngagement:

______to______

FacultyMember’sSignature:Date:

APPROVALS:

Dean of Academic Affairs Signature DateRecommended: Yes or No

*IfNotinCompliance,reasons: ______

______

President,ordesignee,Signature:

Research/ConsultingComplianceForm06/2014

AppealProcessforNegativeDecisiononComplianceForm

for

ReportingofResearchorConsultingwithOutsidePublicorPrivateEntity

1.Afacultymembermayappeal,inwriting,totheBORVicePresidentforHumanResourceswithinten(10)calendardaysuponreceivingwrittennoticethattheoutsideworkwasnotincompliance.

2.ThefacultymembershallreceiveawrittenresponsefromtheBORVicePresidentforHumanResourceswithinten(10)calendardaysstatingthereasonsforthedecision.

3.ShouldthefacultymemberdisagreewiththedecisionoftheBORVicePresidentforHumanResources,thematterwillbesubmittedtotheOfficeofStateEthicswithinten(10)calendardaysfromthedaythefacultymemberreceivestheresponse. TheBORVicePresidentforHumanResourcesmayelecttosubmitthematterdirectlytotheOfficeofStateEthicsforitsopinion. ThiselectionbytheBORVicePresidentforHumanResourceswouldsatisfytheobligationtorespondasstatedinparagraph#2.

4.ThedeterminationbytheOfficeofStateEthicsshallbefinalandnotsubjecttothegrievanceprocedure.

Research/ConsultingComplianceForm06/2014