Campus: Select One

President’s Office Form 19PURDUE UNIVERSITY

Revised July, 2014APPOINTMENT TO THE FACULTY

Campus: Select OneWest LafayetteCalumetFort WayneNorth Central

Type of Appointment: Select OneNewNew-RevisedExtension/Change Personnel No.(if Extension or Change)

LastFirstMI

Organizational Unit Name: / FTE:
Position Title:
Organizational Unit Name: / FTE:
Position Title:
Organizational Unit Name: / FTE:
Position Title:

PERIOD OF APPOINTMENT: BEGIN DATE: (Month, Day, Year) END DATE: (Month, Day, Year)

End Signifies: Select OneReview of Appointment DateTermination Date without Further NoticeN/A

ANNUAL RATE OF PAY FOR THIS APPOINTMENT $on anSelect Oneacademicfiscalyear basis

or(budget year )

CASH RATE OF PAY FOR THIS APPOINTMENT $

Are there any other agreements affecting the terms and conditions not covered by this document? Select OneYesNo

If “Yes”, note terms and conditions or attach documentation of these agreements and list all document(s) attached.

ATTACHMENTS/:1.

COMMENTS2.

3.

FACULTY TENURE STATUS:(Check One)

New Appointment: Select OneAppointed with TenureNot eligible for TenureEligible for Tenure: Waiting(Reference Tenure Date Below if applicable)

Extension/Change in Tenure Status: Select OneTenuredNot eligible for TenureEligible forTenure; WaitingChange in Maximum Probationary PeriodOther (explain below)(Reference Tenure Date Below if applicable)

Explain (if applicable):

Date Tenured/Day Following End of Maximum Probationary Period:(month,day, year)

Are there any Conditions regarding Tenure:Select OneYesNoYes-contingent upon appropriate immigration status. If “Yes”, note conditions or attach documentation of these conditions.

ATTACHMENTS/:1.

COMMENTS2.

The individual named above is hereby appointed to the faculty of PurdueUniversity for the limited term stated above, and hereby accepts such appointment of the terms and conditions provided herein and in Executive Memorandum No. B-50 (Terms and Conditions of Employment of Faculty members), or succeeding documents, which by this reference is made part of this Agreement. This Agreement will become effective when it is signed by the individual named above and signed by the President as authorized by the Board of Trustees, or signed by a duly authorized designee of the President.

The term of this appointment, as to a non-tenured faculty employee, may be extended only by the execution of a Form 19, except that if tenure is attained during or at the expiration of the term of this appointment, extension of this appointment will be governed by the provisions of Executive Memorandum No. B-50, subject to the provision of Executive Memorandum No. B-48, as revised or supplemented from time to time, Except as noted above, this Agreement and Executive Memorandum No. B-50 contain all of the terms and conditions of employment. The undersigned appointee understands that it is his/her responsibility to become acquainted with those Executive Memoranda and University policies which are related to Purdue employment, including but not limited to, B-4, I.A.1, B-48, and the Faculty and Staff Handbook.

AGREED: ______

(Appointee)(Date)(Org. Unit Head)(Date)

APPROVAL

RECOMMENDED/

RECOMMENDED:______APPROVED:______

(Vice President/Dean/Vice Chancellor/Director)(Date)(President or Designee)(Date)

Distribution: Original-Human Resource Services / Copy – College or School / Copy – Department / Copy – Individual