HR Request for Letter of Appointment with Benefits

Requester Name:

First NameLast Name

Requester Title:

Requester Department:

Requester Division/Unit:

Requester Email:

example@tmcc.edu

Requester Phone Number:

Please enter a valid phone number.Format: 000-000-0000.

Employee Information

The following individual is being proposed to be employed at greater than .5 FTE for a period of more than 80 hours in a month in accordance with NAC 287.150. The Letter of Appointment is only approved one semester at a time for teaching faculty or a one-year period for an hourly employee:

Employee Type:

Instructor Name:

First NameLast Name

Employee Name:

First NameLast Name

Semester:

Start Date:

End Date:

Department:

Course(s) Being Taught

1) Course:

Section:

Credits:

2) Course:

Section:

Credits:

3) Course:

Section:

Credits:

4) Course:

Section:

Credits:

5) Course:

Section:

Credits:

6) Course:

Section:

Credits:

Has the part-time instructor pool been consulted?

The following instructional condition(s) have occurred and have been justified for this LOB contract:

Rows	Yes	No
1. No other part-time faculty can be assigned to the section. The part-time pool has no other individual(s) qualified or available to teach the section.
2. The part-time's prior assignment cannot be reassigned, which would free up the part-timer to be assigned to the section.
3. A full-time faculty cannot be reassigned, which would free up a section that could be assigned to a part-timer.
4. The section cannot be canceled due to high enrollment or the students cannot enroll in another section or course to satisfy their graduation/certification requirement.

The following non-instructional condition(s) have occurred and have been justified for this LOB contract:

Rows	Yes	No
1. No other part time employee is available or can be assigned the work.
2. The part-time employee’s prior job duties cannot be reassigned, which would free them up to work on this additional workload.
3. A full-time employee cannot be given this extra work to free up work that could be assigned to a part timer.
4. The work must be completed due to demand.

Has this request been discussed and approved through the supervisory chain to the Vice President?

Provide a brief rationale of what the LOB request is for and why it is necessary:

Briefly describe the efforts made in recruiting part-time faculty:

Validation/Comments:

Certification and Acknowledgment

By pressing submit, I verify that Ive read and understand all of the guidelines and information provided regarding this request.

Please verify that you are human:

Sender Name: