EBRPSS Personnel Recommendation Form for Certified/Licensed Personnel

EBRPSS Personnel Transaction Form for Summer Employment

(To be completed for hiring and budget assignment)

COMPLETE BY PRINCIPAL / SUPERVISOR (complete electronically, save, print, sign, and submit to HR)
NAME / EMP# (SSN if new)
POSITION / LOCATION
WORK STATUS / Part Time / Temporary / Extended Time
Summer
LENGTH OF EMPLOYMENT / 3 months
HIRING STATUS / New Hire
Current Employee
Replacing: / Emp#
FUNDING SOURCE / General Fund / Other
Requested beginning date / Ending date (temp or sub)
(Beginning date will be determined by the Human Resources Department, and employee should not start until approved by the appropriate supervisor in Human Resources)
RECOMMENDED BY / DATE
POSITION
COMPLETE BY HUMAN RESOURCES
CERTIFICATION
o Certified / o OS / o Practitioner Teacher License / o 1 / o 2 / o 3 / o 4
HIGHLY QUALIFIED / o Yes / o No
Basis for Decision / ______
EFFECTIVE DATE / BEGINNING DATE / ______/ ENDING DATE / ______
Hourly Rate / ______/ OR / Daily Rate / ______
SIGNATURE / ______/ DATE / ______
COMPLETE BY FEDERAL PROGRAMS
This is an approved position / o Yes / o No / FUNDING SOURCE / ______
ACCOUNT NUMBER TO BE CHARGE / ______EIC/GRANT ______
SIGNATURE / ______/ DATE / ______
COMPLETE BY FINANCE DEPARTMENT

OHR Revised 2011 06

COST CENTER / ______/ TYPE CODE / ______/ PERCENTAGE / EIC/GRANT / ______
COST CENTER / ______/ TYPE CODE / ______/ PERCENTAGE / EIC/GRANT / ______
COST CENTER / ______/ TYPE CODE / ______/ PERCENTAGE / EIC/GRANT / ______

OHR Revised 2011 06

PSTN3: DEFAULT GL# / ______.______.* * * * 00.______/ OR DELETE EXISTING DATA / ______
APPROVAL SIGNATURES / Approved:
o Yes / o No
Millie L. Williams, Interim Exec. Dir. For Human Resources / Date
o Yes / o No
Catherine Fletcher, Chief Business & Operations Officer / Date

OHR Revised 2011 06