To: Unit Executive Officer
I, __________________________ , hereby request permission to be employed by the
University for the following
(Name, typed or printed)
summer period in addition to my academic year appointment:
From: ______________________ to: ___________________ at: __________ % time.
I certify that the work will be performed during the period for which compensation is requested.
I understand that this summer appointment decreases or eliminates my vacation time for the year.
I also understand that this appointment will be incorporated in the Faculty Activity Analysis System for documentation of compensation for personal services.
__________________ ____________Signature Date
__________________ ____________ _______________ ___________
____________________ ______________ __________________ _____________
Principal Investigator's Signature Date
*This form is required for faculty who exceed 2/9ths summer @ 100% rate. It is also required for graduate students who held an appointment of 50% or more for the prior academic year (fall & spring) and who exceed 2/9ths summer @ 67% rate. This form must be submitted/retained at the departmental, college, or administrative unit level as required.
**This applies to individuals who are being employed in a unit outside of their home unit for the summer.
Rev: 07/11/01 Document1