U NIVERSITY OF C ALIFORNIA O FFICE OF THE P RESIDENT
Request to Add/Renew/Change Position
TO: Regional Director
CC: Debbie Pichla International Hr Analyst
Division: Academic Affairs Department: Education Abroad Program
1. Study Center:
2. Position Title:
3. Name of Individual:
4. Current Position Salary:
5. Proposed Position Salary:
6. Action Type
New Position* Replacement* Contract Renewal*
Position Reclassification/Change in duties* Salary Adjustment Change in Percentage of Time
Leave of absence Termination
*Requires submission of job description/list of services for service contracts
7. Effective Date (include start and end dates, if leave of absence)
8. Type of Appointment for Proposed Position, Replacement
Career Independent Service Provider Fixed Term/Temporary
9. Proposed weekly percentage of time for the position and number of hours per week:
10. If proposed appointment type is not career, # of months of appointment and start/end dates:
11. Is this an extension of a current appointment? Yes No
Created by dpichla 10/31/2012
Request to Add/Renew/Change
12. Rationale for requested action: Provide a detailed rationale for the request and include budget impact.
13. Budget Information (To be completed by UOEAP)
Source of Funding: Permanent Funding Temporary Funding FAU: M 406210 19900 sub 1
Regional Director Review: Date:
Human Resources: Date:
REQUIRED FOR NEW POSITIONS, REPLACEMENTS AND SALARY ACTIONS:
Finance Director Review: Date:
Executive Leadership Review: Approved Not Approved
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Request to Add/Renew/Change
Guidance for Completing the Request to
— All requests will be reviewed with consideration given to both host country and UC labor practices —
o If you need assistance completing the form please contact Debbie Pichla, email@example.com
o Tip: Check the boxes by placing the cursor at the space directly in front of the box you want to select and double click.
The check box form will appear and you can select the “checked” default value.
o If you are requesting multiple positions with the same title and contract duration you may use a single form (i.e.
temporary summer help)
o Requests may be modified by UOEAP to reach mutual agreement
o Approval of the request does not make it permanent. UCEAP reserves the right to modify terms and conditions of all
contracts in accordance with applicable regulations and our business needs.
Question 1: Enter your Study Center location (i.e. France – Paris)
Question 2: Enter position title. This should be the current title or proposed title if it is a new position being requested.
Question 3: Provide name of employee or service provider
Question 4: Provide current annual salary. This may consist of a base amount only or base + other forms cash
compensation where the salary is structured with additional components.
Question 5: Provide proposed annual salary
Question 6: Indicate what action is being requested. A job description is required for requests to add, replace, or
change a position.
Question 7: Indicate the requested effective date of the change
Question 8: Select the type of appointment
Question 9: Proposed weekly percentage of time, full-time or part-time and number of hours per week. If contracted hours
will vary, please indicate number of weeks at ____ hours/week for each period that varies.
Question 10: Provide duration of Independent Service Provider contracts and fixed-term/temporary contracts, including
start and end dates.
Question 11: Indicate if the appointment request is an extension of an existing contract.
Question 12: Provide rationale for the change request. Consider the following:
o What change or changes have occurred at the Study Center to necessitate the request
o How will this change affect other positions within the Study Center (i.e. request for temporary staff or change in job duties)
o How much will it cost (consider salary and employer taxes where applicable)
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