Academic Personnel Action Summary (UCI-AP-22)

Name

School

Department

Proposed Action*

Effective Date

Appt Percent

Dean DelegatedNon-Senate Action (attach UCI-AP-137)Accelerated

Yrs Accel

Present Status
Title:
Step:   Number
Years at Rank:   Number
Years at Step:   Number
Present Salary:       Off-Scale
Salary Scale:
Basis/Paid Over:

Proposed Status
Title:
Step:   Number
Years at Rank:   Number
Years at Step:   Number
Proposed Salary:         Off-Scale
Salary Scale:
Basis/Paid Over:

Years toward 8-year rule, if applicable. Please explain any extensions to the 8-year rule:

UC Academic Employment History (if any)

Rows	Dates	Title	Step	Institution/Campus
1
2
3

Rows	Review Action	Modify: Other Recommendation	Signature	Print Name	Date
Chair
Dean

If campus review is required:

Rows	Review Action	Modify: Other Recommendation	Signature	Print Name	Date
Ad Hoc
CAP
Vice Provost
Provost & EVC
Chancellor

Updated 01/26

UCI-AP-22

Academic Personnel Action Summary

Recommendations and Approvals: