Partial Year Employment Agreement Form
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Human Resources
Partial-Year Employment Agreement
Date submitted
(Policies & instructions on page 2)
Employee Name_________________________________________ Employee ID No. ________________________
Job title & code ________________________________________________________________________________
Department Name / Account Number _______________________________________________________________
Budget Position No. ____________________________________ Pay Type ________________________________
Designated WORK period
___________ / ___________
through ___________ / ___________ annually
month
day
month
day
Designated LEAVE period
___________ / ___________
through ___________ / ___________ annually
month
day
month
day
This is a continual agreement; any deviation from these dates will require a new partial-year employment agreement.
During the partial-year leave period, the employee may elect to maintain his or her insurance coverage. Please make ONE selection below:
Prior to the leave period, I will make a payment directly to the Employee Benefits Department for my contribution amount for the
entire partial-year leave period
I wish to be billed monthly by Employee Benefits during the leave period
Please take premium deductions from my paychecks upon my return after the leave period
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Nonpayment of your premiums will result in cancellation of coverage.
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Eligible employees who elect to drop coverage during the leave period may reapply for coverage within 31 days
after returning from partial year leave, but will be treated as new group members. Contact Employee Benefits at
706-542-2222 if you wish to drop coverage during the leave period.
Partial-year employment is a management and budgeting tool which allows employing units to concentrate the support staff work
force during peak demand periods and to reduce the number of support staff during low demand periods. Partial-year positions are
designed for employment during a predesignated specific period of the year for a time frame not less than nine consecutive months.
The designated work time shall be referred to as the “partial-year employment period” and the remainder of the year shall be referred
to as the “partial-year leave period.” The partial-year agreement form designates the leave period and additional leave approval forms
are not required. Partial-year positions are considered to be regular, classified positions and individuals employed in this category
have the same rights and privileges as any other regular University classified employee. However, due to the nature of the partial-year
employment type, some differences do exist.
Partial-year employees are not eligible for holiday pay for those holidays occurring during the designated leave period nor are they
eligible to receive unemployment compensation benefits during this period.
The signatures below merely represent agreement and approval of the partial-year employment status, including the provisions
covering the continuation of insurance eligibility during the designated leave period and do not establish or imply any contractual
employment agreement not extended to other regular classified employees.
Employee’s signature _____________________________________________________
Date
Dean/Director/Department Head _____________________________________________
Date
Please submit this signed form to Human Resources: Fax 706-542-7321
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April 9, 2014
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Parent category: Business