Cabinet Personnel Action Request

  1. Complete all fields below and submit the request to your Vice President for consideration.
  2. If approved, the Vice President will forward the form to theVice President of Human Resources and Labor Relations.
  3. Results of your request will be made known to you the day following the Cabinet meeting.

Date of Request: January 25, 2019

  1. Cluster:

JB 07/17/2017

Cabinet Personnel Action Request

  1. Position Title: Classification:

Position Location: Position Replacing:

  1. This is a new positionwith a new job description (attach job description).
  2. This is a new position with an existing job description (attach job description).
  3. This is a replacement position using the existing job description (attach job description).
  4. This is a replacement position restructuring the existing job description(s) (attach revised job description(s)).
  5. This is a reclassification of a current position using an existing job description (attach job description).
  6. Please describe in detail how this will hire affect the 50% rule?
  7. This position should be advertised as bilingual required, preferred or desirable and meets the following guidelines (1) The position directly interfaces with students and/or public and (2) the department experiences high demand for the identified language skills (oral and/or written).: (Justification)
  1. Position Details:
  1. The proposed position, if approved, will be (FTE )

(Months )

  1. Current salary range (see current job description):
  2. Range
  3. Monthly Salary (see salary schedule, multiply by FTE% if less than 1.0 FTE)
  4. Cost of Employer Paid Benefits

(PERS, FICA, Medicare, SUI, Workers’ Comp = 24.271%, if less than 50% no PERS only FICA, Medicare, SUI, and Workers’ Comp =8.74%) (STRS, Medicare, SUI, and Workers Comp = 16.97%)

  1. Cost of Bilingual Stipend
  2. Cost of Health and Welfare Benefits:

(Costs are annual prices and reflect single only coverage from Classified allocation)

Monthly Salary
(x) (6 b.) / Months Working in Fiscal Year (x) (5.) / Bilingual Stipend
(if applicable)
5%
(9.) / Employer Paid Benefits (24.271 or 8.74 PERS or 16.97 STRS)
(7.) / Health and Welfare Benefits
(8.) / Approximate Total Annual Salary
(includes all benefits)
$ / % / % / $ / $0.00
  1. Funding Source/ Account String (Please enter below)

Source of Funds / Fund / Organization / Account / Program / Activity / Percentage
0
  1. Justification (Required Documentation listed on item #5):
  1. Justification Narrative (Narrative must include impact on services or projects, current and future workload, what would happen if the position was not filled, and how the position provides support to the District Mission):
  1. Please explain in detail any regulatory requirements associated with this position:
  1. Please explain in detail if this position affects health and safety operations or programs:
  1. Fiscal impact:

Savings (explain in detail):

Cost neutral (explain in detail):

Requires an increase in the established budget (explain in detail):

  1. Required Documentation/ Attachments:

Job Description (lined out version if revised)

Five-Year Cost Projections

Current Organizational Chart

Future Organizational Chart (with workflow)

Requestor:

SignaturePrinted NameDate

Dean/Director:

SignaturePrinted NameDate

Vice President/President:

SignaturePrinted NameDate

Vice President Human Resources (Final Review):

Signature Melissa RichersonDate

Human Resources will complete this portion

Cabinet Meeting Date: Action taken at Cabinet: Approved Comments: Tabled

Denied

Union Approval Date: (when applicable)

Comments:

Recommended for action at the Board of Trustees meeting (when applicable)

JB 07/17/2017