Academic Non-Senate Position Request Form

ACADEMIC NON-SENATE POSITION REQUEST FORM

SUPERVISOR INFORMATION
Name (First Last):Click here to enter text. / Title:Click here to enter text.
Email:Click here to enter text. / Department:Click here to enter text.
Employee ID:Click here to enter text. / Hiring Manager (if different):Click here to enter text.
RECRUITMENT INFORMATION
Working Title:Click here to enter text. / Position: / ☐ New; Position #: Click here to enter text.
Payroll Title(if no position #):Click here to enter text.
Title Code(if no position #):Click here to enter text.
Work LocationChoose an item.
Number of Openings: 1 (default)
Supervisor: Click here to enter text. / ☐ Replacement for Click here to enter text.
Duties of Position (Summaries responsibilities: include supervision, report preparation, etc.):Click here to enter text.
Positions to be supervised: Click here to enter text.
Required Qualifications: (degree, field, professional experience, etc.):Click here to enter text. / Preferred Qualifications: (degree, field, professional experience, etc.):Click here to enter text.
POSTING INFORMATION
Posting Length(period open for applications): / Additional Employment Requirements:
☐ 2 Weeks Min. ☐Other: Click here to enter text. / ☐ Background Check
Post to these Sites / ☐ Other(specify): Click here to enter text.
☐ UCB Jobs ☐ Post to these sites:Click here to enter text. / Job Posting Text
Advertising Budget $ Click here to enter text. / HR AP Partner will provide you with a preview of your job ad for approval
Outreach to be done by faculty - List sources: Click here to enter text. / ☐ List Salary Range Click here to enter text.
☐ List Percent Time: Click here to enter text.
HERC Category: Choose an item. / Application Documents (CV, cover letter, statement of research, references, etc.):Click here to enter text.
FUNDING INFORMATION
Budgeted FTE / Dist. % / GLBU / Fund / Org/Dept / Program / Chartfield 1 / Chartfield 2
Funding for Salary & Benefits
Funding for Salary & Benefits
Funding for Salary & Benefits
External Advertising (if different)
SEARCH COMMITTEE (list full names as in HCM)
Click here to enter text.
ADDITIONAL SUPPORT
☐ Application reviews (recruiter will contact) / ☐ Schedule interviews
☐ Phone screens / ☐ Conduct Reference Checks
☐ Draft/recommend interview questions / ☐ Additional Short Ad Required
Other notes: Click here to enter text.
APPROVALS (as needed)
Attach email approval if needed in lieu of signature below
Fund Manager / Name: Click here to enter text. / Signature:
Attached: ☐ Draft Job Ad ☐Short Ad ☐ Other Click here to enter text.

Updated March 2017