ࡱ>  bjbjVV ܪ<< DSSS<S$0T$$$$$$$%($:::$4$!!!::$!:$!!! d sStF!#$0$! )H )! )!lL16!g,$$ $:::: ) : FACULTY APPOINTMENT APPROVAL FORM This will become the formal notice of appointment upon completion of all approvals listed.Legal Name: FORMTEXT      Soc. Sec. No.: FORMTEXT      Banner ID: FORMTEXT      POSITION/JOB INFORMATION FORMCHECKBOX  New  FORMCHECKBOX  RenewalPersonnel Bulletin No.:FY  FORMTEXT      Previous Incumbent: FORMTEXT      Campus:  FORMCHECKBOX  SIUC  FORMCHECKBOX  Alton  FORMCHECKBOX  E St Louis  FORMCHECKBOX  Edwardsville  FORMCHECKBOX  SpringfieldBox FORMTEXT     Bldg. & Rm. No.  FORMTEXT      Phone w/Prefix: FORMTEXT      **Please do not use the delete key or backspace key in the Hrs. Per Pay column or the Actual Assign Salary column.** POSN TITLE/RANKPOSN No.Full-Time Semi-Mo Salary BaseAppt. Percent: (4 decimal places max., e.g., 33.33)**Hrs. Per Pay (F9 to calc)**Actual Assign Salary (F9 to calc)Account TitleOrg/ DDU AIS Budget Purpose  =.8156*D1 \# "0.00" 0.00 =PRODUCT(C1,D1)*.01 \# "$#,##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: FORMCHECKBOX  Continuing: FORMCHECKBOX  Academic  FORMCHECKBOX  Fiscal*Beginning  FORMTEXT       (term/yr or mo/day/yr)*If fiscal, normal fiscal year will be from: FORMTEXT       (mo/day)through  FORMTEXT       (mo/day) each year. FORMCHECKBOX  Summer Academic**Beginning  FORMTEXT      (mo/day/yr)through FORMTEXT      (mo/day/yr)(A continuing appointment is renewed automatically each year, excluding Summer, unless the appointee is given notice as specified in the applicable personnel policies. Summer appointments assigned to continuing, tenure-track faculty do not count toward tenure.) **Subject to July 1 salary increase when applicable unless otherwise noted below as a condition of appointment. FORMCHECKBOX  Term: FORMCHECKBOX  Academic  FORMCHECKBOX  FiscalBeginning  FORMTEXT       through  FORMTEXT        FORMCHECKBOX  Summer Academic**(term/yr or mo/day/yr)(term/yr or mo/day/yr)(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. If an appointment period set forth under a collective bargaining agreement conflicts with this provision, the collective bargaining agreements terms and conditions shall prevail.) **Subject to July 1 salary increase when applicable unless otherwise noted below as a condition of appointment.CONDITIONS OF APPOINTMENT/DESCRIPTION OF RESPONSIBILITIES: (Include position description. Attach a 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 tF   0 2 4 > @ B ` b ˳{hYA,(jhphw8wCJOJQJU\^J/hphw8w5B* CJOJQJ\^JaJphhphw8wCJOJQJ^J%jhphXCJOJQJU^J+jhphwCJOJQJU^JhphaCJOJQJ^J%jhphaCJOJQJU^J/hphw8w5B* CJOJQJ]^JaJphh,rhph,rCJOJQJ^J&hph,r5CJOJQJ\^JaJjhph,rCJUJ   B ` $Ifgd:pTkde$$Ifl0@ (  t4)44 laytp $$Ifa$gdp b v x z ­}e­VRVRDhphw8w5OJQJ^Jhw8whphw8wCJOJQJ^J.jhphw8wCJOJQJU\^J/hph5B* CJOJQJ]^JaJph/hphw8w5B* CJOJQJ]^JaJph(jhphXCJOJQJU\^J(jhphw8wCJOJQJU\^J.jBhphw8wCJOJQJU\^Jhphw8wCJOJQJ\^J ^U $Ifgd#okd" $$IflֈP<#(X       t4)44 laytp 6 l  $$Ifa$gdp $Ifgd#oHkd $$Ifl(4) t4)44 lap ytp   " & 6 8 T V X l ӸӧzbK3/jo hphw8wCJOJQJU^JaJ,hphw8w5B* CJOJQJ^JaJph/hphw8w5B* CJOJQJ\^JaJph/j hphmCJOJQJU^JaJ)jhphw8wCJOJQJU^JaJ hphw8wCJOJQJ^JaJ5j hphm6CJOJQJU]^JaJ&hphw8w6CJOJQJ]^JaJ/jhphw8w6CJOJQJU]^JaJ      , . 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It is a condition of employment that each appointee agrees to abide by the provisions of the University Patent and (or) Copyright Policy and any contractual obligations of the University to others with reference to discoveries, inventions, improvements, composition or creations made, produced, developed, actually or constructively reduced to practice or perfected during the term of employment.Appointee s Signature DateI am a retiree, as defined by the State Universities Retirement system.  FORMCHECKBOX  yes  FORMCHECKBOX  no FORMCHECKBOX  As defined by the Office of the Secretary of State and based on the responsibilities assigned to this position, the employee will be required to complete a Statement of Economic Interest. URL for filing information, including criteria: http://www.siu.edu/~ethics/econint.htm RECOMMENDATION: Chair/Supervisor Signature & DateDean/Dir./Fiscal Officer Signature & DateVice Chancellor Signature & DateChair/Supervisor Signature & DateDean/Dir./Fiscal Officer Signature & DateVice Chancellor Signature & DateACCEPTED BY DIRECTOR OF HUMAN RESOURCES: DateAPPOINTMENT: Subject to the requirements of the Board of Trustees' Policy on Personnel Approval, you are hereby appointed to the position described above.CHANCELLORDate Date approved/ratified by President:Date ratified by Board of Trustees: FICA  FORMCHECKBOX  SURS  FORMCHECKBOX  Medicare  FORMCHECKBOX  7/10     RtTttttt $Ifgd#o $IfgdmkdA@$$Ifl(4) t04)44 lap ytpttuH? $Ifgd3xkd@$$Ifl\< !(( t04)44 lap(ytp$u&uBuDuFuZu\uxuzu|uuuuuuuuuuwww׾ץס|o[|oLoHhfIhphfICJOJQJaJ'jDhphCJOJQJUhphfICJOJQJ!jhphfICJOJQJUhhph5CJOJQJ^JhY 1jBhphOE5CJOJQJU\^J1jKBhphOE5CJOJQJU\^J"hphY 5CJOJQJ\^J+jhphY 5CJOJQJU\^Juuu $Ifgd okd7C$$Ifl (4) t04)44 lap ytpuuw $IfgdfIokdC$$Iflp(4) t04)44 lap ytpwwx $Ifgd okdD$$IflP(4) t04)44 lap ytpwwxxxx xxxTxVxxxxxxxxxxx@yByyyyyy,z>z@z\zv{x{z{{{8|:|<|>|N|ƴƴƤƤƤƤƤƤƤƤƕՉ}qh3~CJOJQJaJh7tCJOJQJaJhXCJOJQJaJhphfICJOJQJ^JhphfICJOJQJ\^J"hphfI5CJOJQJ\^JhphfICJOJQJ^JhfI+hphfI5B* CJOJQJ\^JphhphfI5CJOJQJ^J)xxxxx x xx $Ifgd#ookdE$$Ifl(4) t04)44 lap ytpxxTxVxx0''' $Ifgd#okdEF$$Iflr$ l( p \  t04)44 lap2ytpxxxxx)kdG$$Iflr$ l( p \ t04)44 lap2ytp $Ifgd#oxxxxx $Ifgd#oxx@yBy0' $Ifgd#o $Ifgdkd I$$Iflr$ l( p \  t04)44 lap2ytpByyyy $Ifgd#o $Ifgdyy.z0z2)) $Ifgd#okdJ$$Iflr$ l( p \  t04)44 lap2ytp0z2zz@zx{6- $IfgdGkd7L$$Ifl\< !(L\  t04)44 lap(ytp $Ifgd#o $Ifgdx{z{{{{{ $Ifgd#ookdM$$Ifl(4) t04)44 lap ytp{{{{{6|8|H??6?6 $Ifgd#o $Ifgdkd7N$$Ifl\< !(XP t04)44 lap(ytp8|:|JECCCCCgdXkdO$$Ifl\ .(     t04)44 lap(ytpN|P|l|n|p|r|||||||||||}}}}~r{ocTLHLHLh]jh]Uhz_h)CJOJQJaJh7tCJOJQJaJhXCJOJQJaJhW-h3~CJOJQJaJh DCJOJQJaJ(jQh3~5CJOJQJU^J(jkQh3~5CJOJQJU^Jh3~CJOJQJaJ(jPh3~5CJOJQJU^Jh3~5CJOJQJ^J"jh3~5CJOJQJU^JgdXhz_h)CJOJQJaJjh]Uh]21h:p7t/ =!`"`#@$`% 8 001h:p / =!`"`#`$`% 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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