C – FOAPAL _____________________________________

EEO/AA Job Code No.___________________Coll/Dept. Code and Name __________________________

Proposed Appointee ____________________________ Gender-Race/Ethnic _______________________

Proposed Appointment Date _____________________________

Proposed Title ____________________________________Current Title____________________________

Proposed Salary ________________________________Current Salary ____________________________

Proposed Department ____________________________ Current Department_______________________

Is proposed appointee currently a Civil Service employee?             ____ yes ____ no

PAPE form attached (for non-faculty positions)                         __________ Not applicable ____ yes ____ no

Basis for waiver:     _____ Internal candidate         _____ External candidate of outstanding   _____ Other special

                                   for major appt.                            achievement                                                    circumstances

                                   _____ Reorganization of unit  _____ Promotion                              _____ Reassignment/transfer

                                  _____ Title change only           _____ Spousal Hire

Reason for request:

PLEASE ATTACH A COPY OF THE PROPOSED APPOINTEE'S CURRICULUM VITAE OR RESUME, LETTERS OF REFERENCE (if available), AND PAPE FORM IF APPLICABLE.

APPROVAL SIGNATURES

___________________________________________________________        _______________________

Dept. Head/Director                                                                                               Date

___________________________________________________________         _______________________

Academic Search Coordinator                                                                                Date

___________________________________________________________         _______________________

Dean/Administrative Officer                                                                                    Date

__________________________________________________________          _______________________

Campus Affirmative Action Officer                                                                           Date 

The University of Illinois at Chicago Waiver FORM REV. 7/03