NOTE AUTHORIZATION TO HIRE IS CONTINGENT UPON BUDGET CONFIRMATION

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					       NOTE: AUTHORIZATION TO HIRE IS CONTINGENT UPON BUDGET CONFIRMATION BY THE HUMAN RESOURCE DEPARTMENT.
                                                 2007-2008
                                 PERSONNEL ACTION FORM FOR YOUR BUILDING
TODAY’S DATE:                                                    “YOUR” BUILDING NAME:

SECTION 1:
EMPLOYEE NAME:                                                             TELEPHONE:
STREET ADDRESS:                                                            CITY/STATE/ZIP:

SECTION 2:
PLACE AN “X” NEXT TO THE APPROPRIATE ACTION                       EFFECTIVE DATE OF APPROPRIATE ACTION:

           New Hire          (Please attach application)                                    Leave of Absence
           Transfer          (“Within” your building)                                       Non-Renomination
           Resignation       (Please attach resignation letter)                             Retirement (Please attach retirement letter)
           Discharge         (Fill in reason below)                                         Other
PLEASE STATE REASON FOR DISCHARGE:


SECTION 3:
New Position:                   Yes                         No             Hours OR Periods per day:
Title of Position, Program & Grade:                                        Person Replacing:
Area of Certification:                                                     Position ID #:
                                                        "Have you checked references?"
SECTION 4:                                                  (FUNDING INFORMATION)
New or Transfer From:
                Dept:       Account:      Source:          Program:      Object:            Level:       Building:    % Amt.:




Transfer To:
                Dept.:      Account:      Source:          Program:      Object:            Level:       Building:    % Amt.:




For Human Resource Office Use Only
DEGREE:                       EXPERIENCE:                   SALARY GRADE/STEP:                            Contract Status:



Board Action Date:
                                                                  Originator of Personnel Action Form                                  Date
Date Completed:
                                                                  Director of Special Education (For SPED funding only)                Date
cc:
                                                                  Director of Human Resources                                          Date


                                                                  Business Administrator Authorization                                 Date



Revised 9/15/98