UM Human Resources Department

Short-Term/Part Time Academic & Student Appointment

(Please click here for Explanatory Notes)
A. Employee Information:

Surname:

Given Name(s):

Employee Number:

Social Insurance Number:

Student Status:

Graduation Date (enter N/A if not in final year at U of M.):

Employee Status & Type of Legal Document reqd:

B. Position Information:

Position Number (enter N/A if not available):

Position Title:

Faculty/Unit:

Department:

Extended Education:

Position Group:

PSU:

Work Location:

Building:
(e.g., Hospital, if no building name, enter town and province):

C. Appointment Information:

Appointment Start Date (yyyy/mmm/dd):

Appointment End Date (yyyy/mmm/dd):

Salary:

Salary Rate:

Total Hours/Week:
Variable Hours Fixed Schedule
Derived Schedule

Generate commitment in the General Ledger:
Yes No

Default GL:
MUST be a BUDGET g/l, not a grant or billing account
F O P

Is 100% of the salary being paid from the default GL?
Yes No

Grant Funded
Yes No

Billing Account?
Yes No

Paying GL:
F O P % Start Date End Date

F O P % Start Date End Date
(please use Funding Allocation Form for fixed grants or more than 2 accounts)

D. Attachment (Please check as appropriate - secure with a staple or binder clip to prevent loss)

Personal Information Form (required for all new hires in your dept OR where changes have occured)
Direct Deposit (required for all new hires OR where employee has not been paid for 6 months)
Copy of SIN Card (required for all new hires in your dept OR for each appointment for 900 series SIN cards)
Copy of Work/Study Permit (required for each appointment for employees with 900 series SIN cards)
Copy of Child Employment Permit (required for each appointment form when under 16 years of age)

Other Legal Documents

Scheduling form
Funding Allocation form
Position Profile

Appendix:
Reason for not posting (if applicable to CUPE 3909 Student/Sessional appointment)

Comments:

This form is prepared by:

Phone: Date: