University of California, Los Angeles s2

University of California, Los Angeles

Campus Human Resources

Request for Extension of Employment Contract -- Exception to Policy

Please complete and forward to CHR – Employment & Compensation Services

I. Employee Information

Employee Name: Department:

Employee ID: Payroll Title:

Original Contract Begin Date /End Date Total Contract Term:

What has been the total duration of this contract appointment?

II. Explanation/Justification for Request

Please provide the written justification and rationale for this request to extend the contract term beyond the four-year limit (see PPSM Procedure 3 – Types of Appointments.) Approval by CHR is not required if you have conducted an open recruitment for the position and you are converting the position to career status. The following criteria will be used in reviewing requests for exception:

·  Business Necessity – The Department has demonstrated critical operational needs that warrant continuation of the position on a contract basis in lieu of converting the position to career status.

·  Unique Qualifications/Skills – The incumbent possesses special skills (please describe).

·  Funding Circumstances – The Department does not have permanent funding to support conversion of the position to career status.

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University of California, Los Angeles

Campus Human Resources

Request for Employment Contract Exception to Policy

III. Signatures

The request must be signed by the appropriate Department Head and Dean or Vice Chancellor.

Submitted by: Date:

Requesting

Manager/Department Head: Date:

Dean or Vice Chancellor: Date:

VI. Campus Human Resources Review and Approval

Approvals of employment contract extensions beyond 4 years will be reviewed and departments will be notified in writing of the decision or contacted for more information by Campus Human Resources.

For CHR Use only

Approval: Date:

2/8/2010