Labor, Training & Compliance
APPOINTMENT OF SUBSTITUTE FACULTY
HR 105D  rev 4/01

APPOINTMENT OF SUBSTITUTE FACULTY:

NAME:                                                                                      Social Security #:                                   *

ADDRESS:                                                                        Telephone#:                                                   *
 

Name Of Employee 
   To Be Replaced 
  Date
 Reason for Absence
 No of Hours  @ Rate of Pay
(or Units)                    (see below)
 Daily Total

1.		      /        /200 *                          @ $  $

2.		      /        /200
*
   @ $
 $

3.		      /        /200 *
   @ $
 $

4.		      /        /200 *
   @ $
 $

5.		      /        /200 *
   @ $
 $

6.		      /        /200 *
   @ $
 $

7.		      /        /200 *
   @ $
 $
TOTAL
 $
SUBSTITUTE RATE OF PAY
HOURLY RATE
          Charge to 

COLLEGE ACCOUNT #:
 

 
Pay Level Recommended*

A  ………………………….r

B  ……....………………….r

C  …...………….………….r

*Attach supporting documentation 
 Laboratory/                 Lecture Class
Activity Class

  $34.00/hr.                    $51.00/hr.
 

  $36.00/hr.                    $53.00/hr.
 

   $37.00/hr.                    $56.00/hr.

Recommended:                                                                                                                                      *
                                Chair                                                                                                Date

Approved:                                                                                                                                              *
                                Dean                                                                                                Date

Approved for Payment:                                                                                                                         *
                                            Payroll Specialist                                                                Date
 

NOTE 1:   For each new appointment, submit no later than the first day of the new pay period to the Office of Human Resources, AD 252

NOTE 2:   If the substitute teacher has not been appointed as a substitute during the current Academic Year, please attach a  Biographical Information #PF 002-A, Oath of Allegiance #STD 689, Employee Action Request (EAR) #STD 686,  Designee Form #STD243. NOTE:  IRCA I-9 Immigration form must be completed and retained in Department.

 

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