Personnel Action Form - Menlo College

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PERSONNEL ACTION FORM (PAF)
LEGAL NAME
PREFERRED NAME
FIRST
MIDDLE
LAST
HOME ADDRESS
STREET
CITY & STATE
ZIP CODE
HOME PHONE
CELL PHONE
TYPE OF ACTION
EFFECTIVE DATE
New hire
Department change
Leave of absence
Return from leave of absence
Salary change
Supervisor change
Title change or promotion
Name/address/phone change
Resignation
Discharge
Reduce in force
Death
Termination of contract
Other ______________________________________________________________________
EMPLOYEE CLASSIFICATION
Use this space for additional remarks, e.g., if
term is less than 12 months
FACULTY:
Full-time
Temporary
Adjunct
STAFF:
Full-time
Part-time
Stipend
STAFF ONLY:
Exempt
Non-Exempt
ADJUNCT & STIPEND EMPLOYEES ONLY
CONTRACT PERIOD:
START DATE
END DATE
PAY DATES:
FIRST PAY DATE
LAST PAY DATE
DEPARTMENT NAME
DEPARTMENT NUMBER
JOB TITLE
NEW JOB TITLE (if changing)
SUPERVISOR NAME
SALARY
NEW SALARY (if changing)
DEPARMENT MANAGER SIGNATURE
DATE
HUMAN RESOURCES DIRECTOR SIGNATURE
DATE
EVP or PRESIDENT SIGNATURE
DATE
FOR HUMAN RESOURCES USE ONLY
Revised Marcy 2015
PERSONNEL ACTION FORM (PAF)
LEGAL NAME
PREFERRED NAME
FIRST
MIDDLE
LAST
HOME ADDRESS
STREET
CITY & STATE
ZIP CODE
HOME PHONE
CELL PHONE
TYPE OF ACTION
EFFECTIVE DATE
New hire
Department change
Leave of absence
Return from leave of absence
Salary change
Supervisor change
Title change or promotion
Name/address/phone change
Resignation
Discharge
Reduce in force
Death
Termination of contract
Other ______________________________________________________________________
EMPLOYEE CLASSIFICATION
Use this space for additional remarks, e.g., if
term is less than 12 months
FACULTY:
Full-time
Temporary
Adjunct
STAFF:
Full-time
Part-time
Stipend
STAFF ONLY:
Exempt
Non-Exempt
ADJUNCT & STIPEND EMPLOYEES ONLY
CONTRACT PERIOD:
START DATE
END DATE
PAY DATES:
FIRST PAY DATE
LAST PAY DATE
DEPARTMENT NAME
DEPARTMENT NUMBER
JOB TITLE
NEW JOB TITLE (if changing)
SUPERVISOR NAME
SALARY
NEW SALARY (if changing)
DEPARMENT MANAGER SIGNATURE
DATE
HUMAN RESOURCES DIRECTOR SIGNATURE
DATE
EVP or PRESIDENT SIGNATURE
DATE
FOR HUMAN RESOURCES USE ONLY
Revised Marcy 2015

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