Post Graduate Form - Temple University
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1TO BE COMPLETED FOR:
TEMPLE UNIVERSITY
POST DOCTORAL FELLOWS
POST GRADUATE (DOC/FELLOW) REQUISITION
PLEASE DO NOT FILL IN ANY OF THE SHADED BOXES OF THIS FORM
REQUESTING DEPARTMENT/SECTION
POSITION TITLE
DATE PREPARED
POSITION SUPERVISOR/CONTACT NAME
TELEPHONE # OF CONTACT
WORK LOCATION
TU ZIP
EXPECTED START
NEW OR REPLACEMENT
PERSON BEING REPLACED
LENGTH OF
ACT 33? *
CHEM? **
DATE
ASSIGNMENT:
POSTIION DESCRIPTION
*WORK WITH CHILDREN UNDER THE AGE OF 18; “Y” IF ACT 33 REQUIREMENTS APPLY. “N” IF ACT 33 DOES NOT APPLY
**THE EMPLOYEE MAY BE EXPOSED TO HAZARDOUS CHEMICALS; “Y” IF CHEMICAL RIGHT TO KNOW NOTIFICATION IS REQUIRED, “N” IF NOT REQUIRED
TYPE OF APPOINTMENT
SALARY:
POST DOCTORAL FELLOW-NO SERVICES ARE REQUIRED (LETTER STATING “NO SERVICES REQUIRED” MUST ACCOMPANY THIS FORM)
POST DOCTORAL WITH BENEFITS
800
TUid
SSN *
EMPLOYEE’S NAME (LAST NAME, FIRST NAME, MIDDLE INITIAL)
ACTION EFFECTIVE DATE
ORG ID
(MM/DD/YY)
ACTIONS:
SUFFI
PREFIX
BU
EMP STAT
EMPLOYMENT STAT DATE
EMPLOYMENT DATE
REG/TEMP
05
A
T
( ) 0 1 - NEW HIRE
X
(MM/DD/CCYY)
(MM/DD/CCYY)
( ) 14 - REHIRE
FULL/PART
PAY STATUS
SENIORITY DATE (MM/DD/CCYY)
ORIG HIRE DATE (MM/DD/CCYY)
STEWARDSHIP – ORG (LOCATION)
S
-800
(
) F – FULL TIME
(
) P – PART TIME
REVIEW TYPE
REVIEW DATE (MM/DD/CCYY)
EXPERIENCE DATE (MM/DD/CCYY)
P
POSITION
JOB BEGIN DATE
JOB END DATE
JOB CLASS
JOB CLASS ENTRY DATE
PAY RATE ( MONTHLY
PAY RT CD
CONTROL #
(MM/DD/CCYY)
(MM/DD/CCYY)
(MM/DD/CCYY)
BASE 999999.999)
GRADE
STE
%FULL TIME
PAID
PAY CYCLE
FUND – ORG
TIME RPT CD
NORMAL HOURS
A99
100
M1
-800
E
P
FOR
FROM________
T
O________
81
01
SHIFT
JCAHO
HOURLY
DAYS/WK
HOURS/WK
01
RATE
ACCOUNT DISTRIBUTION (ADDITIONAL SPACE AVAILABLE ON BACK OF FORM)
Fund/Org/Account/Program
ERN TYP
RATE/AMT
PERCENT
START DT (MMDDCCYY)
STOP DT (MMDDCCYY)
Fund/Org/Account/ Program
ERN TYP
RATE/AMT
PERCENT
START DT (MMDDCCYY)
STOP DT (MMDDCCYY)
Fund/Org/Account/Program
ERN TYP
RATE/AMT
PERCENT
START DT (MMDDCCYY)
STOP DT (MMDDCCYY)
TOTAL:
RATE/AMT
APPROVALS
FACULTY MENTOR (PRINT)
SPONSORED PROJECTS ADMIN OR GRANT ACCOUNTING (PRINT)
FACULTY MENTOR (SIGNATURE)
SPONSORED PROJECTS ADMIN OR GRANT ACCOUNTING (SIGNATURE)
PRINCIPAL INVESTIGATOR (PRINT)
SCHOOL/COLLEGE REPRESENTATIVE (PRINT)
PRINCIPAL INVESTIGATOR (SIGNATURE)
SCHOOL/COLLEGE REPRESENTATIVE (SIGNATURE)
UNITED STATES CITIZEN?
YES
/
NO
EMPLOYMENT RESTRICTIONS MAY APPLY FOR NON-U.S. CITIZENS, THEREFORE ALL NON-U.S. CITIZENS MUST:
1-SCHEDULE AN APPOINTMENT WITH A NRA SPECIALIST (EXTENSION 1-8793) PRIOR TO BEGINNING EMPLOYMENT
2-ATTACH ONE OF THE FOLLOWING:
-A VALID EMPLOYMENT AUTHORIZATION CARD (EAD)
-FORM I-20 FOR F1 VISA HOLDERS
-FORM DS 2019 FOR J1 VISA HOLDERS
-FORM I797 (NOTICE OF ACTION) FOR H1 VISA HOLDERS
-ALL OTHE RVISA TYPES, CONTACT PAYROLL MANAGEMENT (EXTENSION 1-6011) FOR ADDITIONAL ASSISTANCE
* Temple University requests your Social Security number (SSN) because federal, state, and local law requires the University to report the name, address, and SSN for
certain purposes. Temple University will not disclose your SSN without consent unless it is required to do so by law, or as permitted by the University’s Social Security
Number Usage Policy ( ).
Revised 2/19/2009
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