GROSSMONT-CUYAMACA COMMUNITY COLLEGE DISTRICT
ACADEMIC HIRE FORM
New
Revision:
Additional budget #
Other: ________________
TYPE:
Non-Classroom
Substitute
SITE:
Cuyamaca
Grossmont
District
(PLEASE TYPE OR PRINT CLEARLY IN BLACK INK)
FULL NAME:
Last (As it appears on SS Card)
ID #:
First
(
PHONE #:
)
MI
-
HOME ☐ CELL ☐
ADDRESS:
Street
City
Is Employee working in any other capacity with the District?
Yes
State
Zip
No
If yes, specify in what capacity:
START DATE
/
/
END DATE
/
/
$
RATE OF PAY:
POSITION:
/ Hr.
DEPARTMENT:
BUDGET NUMBER(S):
The above named individual has been hired as follows (check appropriate area(s):
Counselor who will be employed for approximately
hours per week or
Librarian who will be employed for approximately
hours per week or
Other non-classroom academic employee who will be employed approximately
who will be completing the following assignment:
.
Adjunct faculty member who will be performing the following ancillary activity:
for approximately
hours. (Zero load)
Substitute:
Available for
For Absent Instructor
percent.
percent.
hours per week or
percent
,
Department as needed
for the following course(s)
.
Total number of hours assigned weekly may vary depending on department’s needs. The combined hours of all work
assignments in the District may not exceed 694 hours per fiscal year July 1 through June 30, or .67 LED per semester if
combined with a classroom assignment. As a part-time employee, I understand that this assignment is temporary and there
is no guarantee of continuation of assignment from semester to semester.
EMPLOYEE’S SIGNATURE:
Date:
DEAN/DIRECTOR APPROVAL:
Date:
VICE PRESIDENT APPROVAL:
Date:
BUSINESS OFFICE APPROVAL:
FORWARD COMPLETED FORM TO EMPLOYMENT SERVICES
Note: In order for the employee to be paid, all employment paperwork must be completed and processed prior to the 10 th of the
month in order to be paid by the end of that month.
EMPLOYMENT SERVICES/PAYROLL USE ONLY:
Employment Services
Review
Payroll Review
EMPMSTR
PAYASSIGN
BENEINFO
CO/HR Position #: A
EMPLY
EMPOS
TIMESHEET
After Employment Services review copies will be distributed to:
Rev. 12/2014
Payroll
Dean/Department
Employee
MANDTAX
RETPLAN
-
RETFORM
BDEMP
PROCEDURES FOR NON-CLASSROOM ACADEMIC HIRE FORM

The hiring department completes the form each semester.

Employee must sign form and provide appropriate employee hire packet, which may be obtained
from Employment Services. Employee returns completed hire packet materials to Employment
Services.

After this form is completed, and indicated signatures affixed, forward to Employment Services.

Employment Services will distribute copies after processing is completed.