ࡱ>  ~bjbjVV J<<dQQQQDQF!.A|@q s s s s s s t"%s s ! q q е5sQ"] !0F!%%%\L6, \\\s s \\\F!%\\\\\\\\\ : ADMINISTRATIVE & PROFESSIONAL STAFF APPOINTMENT APPROVAL FORM This will become the formal notice of appointment upon completion of all approvals listed.Legal Name: FORMTEXT      Soc. Sec. No.: FORMTEXT      Banner ID : FORMTEXT      POSITION/JOB INFORMATION FORMCHECKBOX  New  FORMCHECKBOX  RenewalPersonnel Bulletin No.:FY  FORMTEXT      Previous Incumbent: FORMTEXT      Campus:  FORMCHECKBOX  SIUC  FORMCHECKBOX  Alton  FORMCHECKBOX  E St Louis  FORMCHECKBOX  Edwardsville  FORMCHECKBOX  SpringfieldBox: FORMTEXT     Bldg. & Rm. No.:  FORMTEXT      Phone w/Prefix: FORMTEXT       **Please do not use the delete key or backspace key in the Hrs. Per Pay column or the Actual Assign Salary column.**  POSN TITLE POSN No.Full-Time Semi-Mo Salary Base Appt. Percent: (4 decimal places max., e.g., 33.33)**Hrs. Per Pay (F9 to calc)**Actual Assign Salary (F9 to calc)Account TitleOrg/ DDU AIS Budget Purpose  =.8156*D1 \# "0.00" 0.00 =PRODUCT(C1,D1)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D2 \# "0.00" 0.00 =PRODUCT(C2,D2)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D3 \# "0.00" 0.00 =PRODUCT(C3,D3)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D4 \# "0.00" 0.00 =PRODUCT(C4,D4)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00GRANTS OFFICE APPROVAL (Grant Accounts Only):Approved by:Date:  APPOINTMENT TYPE & APPOINTMENT PERIOD:Professional Staff (Bargaining): FORMCHECKBOX  Regular  FORMCHECKBOX  DurationalBeginning  FORMTEXT       (term/yr or mo/day/yr)through FORMTEXT      (term/yr or mo/day/yr  durational appts only)If regular, appointment period will be from: FORMTEXT       (mo/day)through  FORMTEXT       (mo/day) each year.(A regular appointment is subject to termination only as provided in the applicable collective bargaining agreement. A durational appointment may be used only for replacement of a regular appointee on leave or for a specific project of a limited duration.)Administrative Staff: FORMCHECKBOX  Continuing  FORMCHECKBOX  TermBeginning  FORMTEXT       (term/yr or mo/day/yr)through  FORMTEXT       (term/yr or mo/day/yr  term appts only)If fiscal, appointment period will be from: FORMTEXT      (mo/day)through  FORMTEXT      (mo/day) each year.(A continuing appointment is renewed automatically each year unless the appointee is given notice as specified in the applicable personnel policies. A term appointment is written for a specified period of time and may be renewed; notice of non-renewal, other than the terminal date of this appointment as stated herein, is not required and shall not be given.)CONDITIONS OF APPOINTMENT/DESCRIPTION OF RESPONSIBILITIES: (Include position description. Attach separate statement if necessary)  FORMTEXT       If related by blood or marriage to any member of the Board of Trustees, please state relationship:  FORMTEXT      READ BEFORE SIGNING: The applicant agrees that if appointed his or her conditions of employment will include the laws of Illinois, including Board of Trustees legislation, and all policies, regulations, including those of SIUE, from time to time issued pursuant thereto, all of which will be as much a part of the applicant's employment contract as if set out in full therein, and that such terms and conditions as from time to time amended will continue to govern in any change of assignment or renewal of the appointment. 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ǸmiVA1h4 hCJOJQJ]^J(jh4 hCJOJQJU]^J%h4 h56CJOJQJ]^Jh%jh4 hCJOJQJU^J+j"7h4 hCJOJQJU^Jh4 hCJOJQJ^J%jh4 hCJOJQJU^Jh4 hCJOJQJ^Jh4 h6CJOJQJ^J"h4 h5CJOJQJ\^J+h4 h5B* CJOJQJ\^Jph $Ifgd#ookd8$$Ifl(4) t04)44 lap yt4   <rDtFtHttt0u2uNuPuRuhujuuӾӬvfQf9QfQf.j~=h4 h85CJOJQJU^J(jh4 h85CJOJQJU^Jh4 h85CJOJQJ^Jh4 hCJOJQJ^JUh4 hCJOJQJ^J"h4 h5CJOJQJ\^Jh"h4 h6CJOJQJ]^J(jh4 hCJOJQJU]^J(jh4 hCJOJQJU]^J.ji9h4 hCJOJQJU]^JFt $Ifgd#ookd:$$Ifl(4) t04)44 lap yt4 tent and (or) Copyright Policy and any contractual obligations of the University to others with reference to discoveries, inventions, improvements, composition or creations made, produced, developed, actually or constructively reduced to practice or perfected during the term of employment.Appointee s Signature DateI am a retiree, as defined by the State Universities Retirement System. Yes  FORMCHECKBOX  No  FORMCHECKBOX  FORMCHECKBOX  As defined by the Office of the Secretary of State and based on the responsibilities assigned to this position, the employee will be required to complete a Statement of Economic Interest. URL for filing information, including criteria: http://www.siu.edu/~ethics/econint.htm RECOMMENDATION: Chair/Supervisor Signature & DateDean/Dir./Fiscal Officer Signature & DateVice Chancellor Signature & DateChair/Supervisor Signature & DateDean/Dir./Fiscal Officer Signature & DateVice Chancellor Signature & DateACCEPTED BY DIRECTOR OF HUMAN RESOURCES:DateAPPOINTMENT: Subject to the requirements of the Board of Trustees' Policy on Personnel Approval, you are hereby appointed to the position described above.CHANCELLORDateDate approved/ratified by President:Date ratified by Board of Trustees: FICA  FORMCHECKBOX  SURS  FORMCHECKBOX  Medicare  FORMCHECKBOX  7/10 FtHtvtxttt $Ifgd#o $Ifgdmkd;$$Ifl(4) t04)44 lap yt4 ttuH? $Ifgd*Wkd%<$$Ifl\< !(TT t04)44 lap(yt4 uuuuuuuuuuwwwxxx xxxxÿ~njTE3E3"h4 h5CJOJQJ\^Jh4 hCJOJQJ^J+h4 h5B* CJOJQJ\^Jphh2h4 h25CJOJQJ^Jh4 h2CJOJQJaJ'j?h4 hCJOJQJUh4 h2CJOJQJ!jh4 h2CJOJQJUhh4 h5CJOJQJ^J(jh4 h85CJOJQJU^J.j=h4 h85CJOJQJU^Juuww~ $Ifgd $Ifgd2okdj>$$Ifl(4) t04)44 lap yt4 wwx $Ifgd okd?$$Ifl(4) t04)44 lap yt4 xx x xxxxx $Ifgd#ookd,@$$Ifl((4) t04)44 lap yt4 xxZx\xx0''' $Ifgd#okd@$$Iflr$ l( p \  t04)44 lap2yt4 xxZx\xxxxxxxxxyyFyHyyyyyy2zBzDz`zz{|{~{{{:|<|B|T|V|r|ͻ~l_h55CJOJQJ^J"jh55CJOJQJU^Jh5CJOJQJaJhCJOJQJaJ+h4 h5B* CJOJQJ\^Jphh4 hCJOJQJ^J"h4 h5CJOJQJ\^Jh4 h5CJOJQJ^Jh4 hCJOJQJ\^Jh4 hCJOJQJ^Jh#xxxxx)kd~B$$Iflr$ l( p \ t04)44 lap2yt4 $Ifgd#oxxxxy $Ifgd#oyyFyHy0' $Ifgd#o $IfgdkdC$$Iflr$ l( p \  t04)44 lap2yt4 Hyyyy $Ifgd#o $Ifgdyy4z6z@z2))) $Ifgd2kdFE$$Iflr$ l( p \  t04)44 lap2yt4 @zBzDz|{?6 $IfgdGkdF$$Ifl\< !(L\  t04)44 lap(yt4 $Ifgd2|{~{{{{{ $Ifgd#ookdH$$Ifl(4) t04)44 lap yt4 {{{{8|:|H?6?6 $Ifgd#o $IfgdkdH$$Ifl\< !(XP t04)44 lap(yt4 :|<|~HCgdkdJ$$Ifl\ .(     t04)44 lap(yt4 r|t|v|x||||||||||}}}}}}}}~̫̟t_SDhW-h:pCJOJQJaJhsCJOJQJaJ(jkLhz05CJOJQJU^Jhz05CJOJQJ^J"jhz05CJOJQJU^Jhz0CJOJQJaJhCJOJQJaJ(jKh55CJOJQJU^Jh5CJOJQJaJh55CJOJQJ^J"jh55CJOJQJU^J(jKh55CJOJQJU^J~~hW-h)CJOJQJaJ21h:p5/ =!`"`#@$% 5 01h:p%/ =!`"`#$% 5 01h:p%/ =!`"`#$% 8 001h:p / =!`"`#`$`% 5 01h:pG/ =!`"`#`$`% 5 01h:pG/ =!`"`#`$`% eDdT  C 0Alogo_150_btb%ǏnZPѧȂa\Dn%ǏnZPѧȂa\PNG  IHDR VtRNS["bKGD̿ cmPPJCmp0712`IDATXGXu8 oqsq3X ':A '8z>,;K{Ad ?b}E]CѓVVXAj䍏RzD5#vFZ>1JۨW;RNg]@%SHHIW3Owm0m^ZFQr u%|TjCn fW: ($7u #i*[EA0Z+~!4^__%h\y劶[lߕ'&_x&Zx j#/m;v7Ek+)|w؁ P֬.m27 CZ l)XYG7EktqpftװR[¢2' -*F'45U )= ғ*,X97peō`KPYxЄ4JO] q|"C%43pMѲ`UڮP;yKaG@^abbK^qKRԺ^Ye6[-Ϫ!<\ ]'CVAiiUڔ`fa2]!slj1d j  5![KK?_ǝT4YSu~q7de58)QKB`،trQ1i)8Hgה-x{~W[VBOq?0jn~ =尰10 .'CAX8^[TɿZ89ZI|ő-\“L's+0 '׿3fw)>Q!6˥3@p>7Hyn3o(NuS;j8yvt?Nv$w"HfD10kC=8? íYqɘP N];W=jTR=%}sM}×Eeԭr7bX-aLl3eܹjl'-m;-I7! 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