Academic Affairs Personnel Data Sheet

*Indicates a required field

Appointment Type (*must select one)

2000 Characters Remaining

Name (as it appears on your Social Security Card or your full legal name)

Home Address:

Phone number(s):

Required for Federal reporting purposes.
If Hispanic, select your Hispanic origins

If non-Hispanic, select race (check all that apply)

Emergency Contact (Atleast One Emergency Contact is Required)

The following two sections are required only if a cv or resume has not been submitted as part of an application packet.
College or University
Degree Type
Date Earned(MM/DD/YYYY) or # Years Attended

Professional Experience - Academic/Non Academic (3 most recent)
Start Date(MM/DD/YYYY)
End Date(MM/DD/YYYY)

Your appointment is predicated upon representations made by you regarding education and experience which if subsequently proven to be incorrect, shall cause this appointment to be void.

For Faculty Appointments:

Full-time faculty appointments are for a 9-month term. The default pay schedule is:

  August ~1/2 month salary;  
  September through April full-month salary;  
  May ~1/2 month salary;  

Pay dates are the last working day of the month.

Faculty may receive salary over twelve months. A portion of each month's salary during the term (academic year) is "deferred" and reserved so that salary is distributed over the summer months, allowing an equal month's salary for 12 consecutive months. Please note: By selecting a 12-month pay plan, your first pay for the academic year will be September 30. If you wish to be paid over twelve months, you must sign and submit the Deferred Pay Authorization . Return it to the Academic Personnel Office one month before you begin employment, or sign it in Academic Personnel Services no later than August 10. This pay plan cannot be implemented after the August payroll is completed and is not available for one-semester or part-time faculty appointments.

Academic Personnel Services
Fax - 513-529-1720
Rm 1, Roudebush Hall, 513-529-6724

Do you wish to submit the form at this time? (Click OK to submit, click Cancel to return to the form)