Position Requisition Transition Form

Please complete form, attach supporting documents and forward to the Office of Human Resources

Empl ID / Empl Rcd # / PIN / Action
HIREPOSTINGUPDATERENEWAL / Current Date:
Applicant Information
Name: (last, first) / County:
Address: / City: / State: / Zip Code:
Employee Class(select one)
Fac Staff / Fac 12 Month / Regular Exempt / Regular Nonexempt / Adjunct
FTNTTFAC / Cont Ex LI / Cont Ex L2 / Cont NE LI / ContNE L2 / Student
1 Fund Source: 2Fund Source: 3Fund Source: / Distribution %: Distribution %: Distribution %: / Budget Use ONLY
1 Account Code: ______2 Account Code: ______
3 Account Code: ______
Employment Department(Select One Dept ONLY)
A – B
Academic AdvisementAcademic AffairsAcademic Support ServicesAccounting & Mgmt Info SystemsAdministration & FinanceAdmissionsApplied Psych & Rehab CounselingAthleticsBachelor of Science in NursingBudget OfficeBusiness Services / C - D
Campus Technology ServicesCapital PlanningCareer Services CenterCtr for Counseling & Student DevelpmtChild Care CenterClient ComputingCollege of Arts/Science and EducCollege of Behavioral/Social SciencesCollege of BusinessCollege of Health ProfessionsCHP-Student Affairs/RetentionCommunity Health CenterControllerCoppin AcademyCrim Justice & App Soc/Pol SciCustodial ServicesDigital Audio/Visual ServicesDisability Support ServicesDoctor of Nursing Practice / E – H
Eagle Card ServicesEnrollment MgmtEvents & Conference ServicesFacilities and Cap Proj & PlanFinancial AidGraduate StudiesHealth and Health EducationHealth Information ManagementHonors ProgramHousingHuman ResourcesHumanities
I - M
Information SystemsInformation TechnologyInst Ldrshp & Prof DevelpmtInstitutional AdvancementInstitutional ResearchInstructional TechnologyInterdisciplinary StudiesLibraryMail ServicesMaintenanceManagement & MarketingMarketing & Creative ServicesMaster of Science in NursingMathematics & Computer Science / N - R
Natural SciencesNetwork SupportOffice of Assoc VP Student AffairsOffice of the PresidentParking & Transportation SvcsPlanning & AssessmentPolice DepartmentPrint ServicesProcurementProcurement & Business Services (AVP)RecordsRecreation & WellnessResidence LifeRosemont Elem/Middle Schl / S - Z
School of Allied HealthSchool of Arts & ScienceSchool of EducationSchool of NursingSocial WorkSport & Entertainment MgmtStudent ActivitiesStudent AffairsStudent Support ServicesTeaching & LearningTelecom & Infrastructure SvcsUniversity College/1st Yr ExpUniversity RelationsWeb Development
Course Information
Course : / Course Level: / Section:
Course : / Course Level: / Section:
Course : / Course Level: / Section:
Course : / Course Level: / Section:
Job Details
Job Code: / Job Code Description:
/ Supervisor:
/ Contractual Staff ONLY
Start Date: / End Date:
Job Duties: (maximum 500 character, including spaces available)
Total Contract (Budget ONLY) / Reg/Temp
RegularTemporary / Full /Part-Time
Full-TimePart-Time / Standard Hrs/Wk / Hours/Day / Days/Week
Contract Amount (Annual Salary) / Daily Rate (Adjunct ONLY) / Hourly Rate / No. Days (Adjunct ONLY) / Work State
Approvals
Originator (Please type or print) / Signature* / Date* / Ext.*
Director/Chair (Please type or print) / Signature* / Date
Dean (Please type or print) / Signature* / Date
Vice President (Please type or print) / Signature* / Date
Title III Director (Please type or print) / Signature* / Date
Budget Office (Please type or print) / Signature* / Date
Office of Human Resources (Please type or print) / Signature* / Date Processed

12/22/2018