TO:
LSC Office of Human Resources
FROM:
SUBJ:
Other VSC Employment/Alternative Work Schedule
I have been offered VSC employment during the regular work day separate from my full-time
position with Lyndon State College for the _____________________ semester or for the time
period specified as follows: [start] __________________ - [end] ________________.
Other VSC employment includes but is not limited to a part-time teaching assignment and/or
separately contracted work with Lyndon State College or another entity within the Vermont
State Colleges. In accordance with LSC policy, I have discussed this opportunity with my
supervisor and we have agreed on a revised schedule of work time that will allow me to accept
additional employment but will still provide full-time commitment to my responsibilities and
will not adversely affect the performance of my duties.
I understand that permission to engage in other VSC employment is not a presumptive right.
My revised work schedule and/or planned use of accrued leave is specified as follows:
Signature: _______________________________________ Date: ______________________
Your typed name above will represent your signature on this form
To be completed by supervisor:
Approved
Disapproved
Signature: _______________________________________ Date: ______________________
Forward to Office of Human Resources.