Joint Appointment Data Collection Form


1. Appointment Information

UID:

Name:

Action:

Type:

Category Status:
	01, Faculty Tenured
	01, Faculty Tenure Track

Position Number:
Title:

Type of Joint:
	J, Permanent Joint
	T, Temporary Joint
	D, Acting & Joint
	C, Retiree & Joint
	V, Previously Tenured or Tenure Track & Joint

Joint Duration
  Start Date:
  End Date:

Search Number:

Nepotism: Yes or No


2. Joint Screen Information

Dept Name:
Dept Code:
Base Salary: $
Admin Increment: $
Empl %:   %
ARS Supgroup:

Dept Name:
Dept Code:
Base Salary: $
Admin Increment: $
Empl %:   %
ARS Supgroup:

Dept Name:
Dept Code:
Base Salary: $
Admin Increment: $
Empl %:   %
ARS Supgroup:

Dept Name:
Dept Code:
Base Salary: $
Admin Increment: $
Empl %:   %
ARS Supgroup:

Total FTE Salary: $
Total of all Base Salary Amounts + Admin Increments(s):


3. Duties

Teaching:    %
Advising:    %
Research:    %
Admin:       %
Other:       %
Desc:


4. Funding

FRS # and %:

FRS # and %:

FRS # and %:

FRS # and %:


5. Courseload

Term:

Course:

# of Sections:

Title: