Employment Form
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1EMPLOYMENT FORM
UNIVERSITY CORPORATION, SAN FRANCISCO STATE
INCLUDE RECOMMENDATION TO HIRE, JOB DESCRIPTION,
INTERVIEW AND REFERENCE CHECK NOTES
TO BE COMPLETED BY PROJECT
EMPLOYEE NAME
BIRTHDATE
SFSU UIN
SFSU EMAIL
HOME ADDRESS
CELL PHONE#
HOME PHONE #
OFFICE #
(street)
(city)
(state)
(zip code)
ACTUAL START DATE
JOB TITLE (attached detailed job description)
PROPOSED
PROPOSED END-DATE
JOB LOCATION
(By UCorp)
START DATE
FUND / PROJECT #
DEPARTMENT # (required)
FUND / PROJECT TITLE (required)
IF SFSU FACULTY:
SUMMER / WINTER INTERSESSION
SABBATICAL
PROPOSED RATE OF PAY
EMPLOYEE IS CONSIDERED
EXEMPT
NONEXEMPT
$ _____________PER HOUR
$ _____________ PER MONTH
NOTE: UCorp will review the job description and determine the appropriate classification, and work with project
administrators on aligning the classification and job duties accordingly.
ARE YOU CURRENTLY EMPLOYED BY SFSU
YES
NO
REGISTERED SFSU STUDENT
YES
NO
IF YES, HOW MANY HOURS PER WEEK ________________
***INCLUDE A COPY OF SFSU EMPLOYMENT JOB DESCRIPTION***
IF YES
UNDERGRADUATE
GRADUATE
CAL-PERS RETIREE
YES
NO
ARE YOU CURRENTLY EMPLOYED BY UCORP?
HAVE YOU BEEN PREVIOUSLY EMPLOYED BY UCORP?
YES
NO
YES
NO
If an employee is hired to work 75% time (30 hours a week) or more, they become eligible for benefits the first of the month following 30 days from date of hire.
EMPLOYEE SIGNATURE: __________________________________________________________ DATE: _______________________
(Candidate will sign in presence of UCorp HR)
PROJECT DIRECTOR’S APPROVAL _________________________________________________ DATE: ______________________
(Required)
COLLEGE DEAN: _________________________________________________________________ DATE: ______________________
(Required)
VICE-PRESIDENT _________________________________________________________________ DATE: ______________________
(Required for all UCorp / SFSU hires)
UNIVERSITY HR __________________________________________________________________ DATE: ______________________
(Required for SFSU Faculty / Staff only)
TO BE COMPLETED BY UCORP
EXECUTIVE DIRECTOR: __________________________________________________________ DATE: _______________________
DIRECTOR A & F: ________________________________________________________________ DATE: _______________________
PROJECT COORDINATOR: ________________________________________________________ DATE: _______________________
UCORP HR: ______________________________________________________________________ DATE: _______________________
FOR USE BY UCORP HR / PAYROLL
EMPLOYEE NUMBER
W/C CODE
SALARY CODE
BURDEN CODE
BURDEN RATE
ADDITIONAL INFORMATIOON
601 - __________
EXEMPTIONS
MARITAL
SEX
NRA WITHHOLDING
EXEMPT FROM
STATUS
ADJUSTMENT AMOUNT:
FEDERAL
STATE
FIT
FICA
SIT
SUI
DI
$
CK PICK UP CODE
AA / EOE CODE
BENEFITED
CALCULATE GTL
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