GATEWAY COMMUNITY COLLEGE

EDUCATIONAL ASSISTANT CONTRACT REQUEST

Requested employee is not authorized to begin work until all authorizations are obtained and required documentation is received and verified by Human Resources.

Section 1 REQUIRED EMPLOYEE INFORMATION:

LAST NAME: / FIRST NAME:
GCC E:MAIL: / TELEPHONE:
New Employee* Current FT Current PT / **Employee 6 digit #

*Prior to this request being received, new employees must complete all HR paperwork. (2 forms of ID required.)

** Leave blank if unknown

REQUIRED ATTACHMENTS:

Weekly Work Schedule for requested employee

Job Description (incl. Job Degree Requirement) If you have submitted a JD and it has not changed, do not resubmit

PLEASE CHECK ALL THAT APPLY:

ADJUSTMENT TO CURRENT CONTRACT (i.e. adjustment to # of credits and/or adjustment to dates.)

REPLACEMENT CONTRACT - REPLACES: _

Section 2 This section must be complete before proceeding.

Does the employee anticipate being employed by a state agency other than Gateway CC during the term of this contract? / No
Yes – Where:
If yes, HR must be notified immediately (via e-mail to ) to verify the employees Exempt or Non-Exempt status in their FT job.
/ Indicate the date that Human Resources was notified:
Does the employee anticipate having an additional part-time contract with Gateway during the term of this contract? (i.e. EA, NCL, etc. do not include their FT job i.e. Faculty/Staff) / No
Yes – Where:

REQUESTS WILL NOT BE CONSIDERED WITHOUT THE ABOVE DOCUMENTATION.

JUSTIFICATION REQUIRED: (Why this position is needed). Do not quote Job Description.

DEPARTMENT: / BANNER ORG: I
PROPOSED
STARTING DATE: / PROJECTED
ENDING DATE:
# HRS / WEEK: / # WEEKS: / RATE** / $ / TOTAL COST: / $

Section 3 EMPLOYEE ASSIGNMENT:

** Determined by degree required to perform the job duties contained in the Job Description.

Is this a Grant funded position? / Yes or No / Name of Grant: / ______

For Business

Fund: ______Org. ______
Acct:______Prg: ______
CF2
HR Position Number:
A new CF2 has been requested
REQUESTED SUPERVISOR
APPROVING DEAN
(verifying section 2 & 3):
BUSINESS OFFICE:
HUMAN RESOURCES:

REQUIRED VERIFICATIONS AND/OR APPROVALS

SIGNATURE DATE

For HR

HR Position Number Verified:
If not – Position# ______
Record # ______

AFTER ALL SIGNATURES ARE OBTAINED, THIS FORM WILL BE FILED IN THE REQUESTED EMPLOYEE’S HUMAN RESOURCES FILE. Rev. 10/2014