Personnel Action Form

Candidate Information

Name: Banner ID:

Please provide information about the candidate and describe his or her qualifications for the position:

If the candidate is being recommended for a faculty position (full-time, part-time or adjunct), the candidate’s educational qualifications must be vetted against the Faculty Qualifying Credential document. Please describe in detail the candidate’s qualifications in accordance with this document.

Candidate Qualifications/Requirements

Does the candidate meet required qualifications as noted in the advertisement and corresponding job description?


If this position requires the candidate to drive for College business, did the candidate pass the MVR check, which is conducted by Human Resources?

Yes No

All regular (non-temporary) positions require the candidate to successfully pass a background check. Did the candidate successfully pass this assessment?

No Not Applicable

If the candidate will be working in a regular (non-temporary) position, did you contact Human Resources to check on the candidate's KPERS status?

Yes No

Is the candidate a KPERS retiree?

Yes No

Position Information

Position Title:

Hiring Supervisor: Office or Program:

Position No. (if existing position):

Location: If Other, please describe:

Position Classification:

If a part-time (non-temporary) regular position, enter annual hours:

and number of weeks worked per year:

If candidate is not a current employee, is being hired into a (non-temporary) regular position, and the Board has yet to approve his/her hire, then the language "Hiring contingent upon Board approval." must be communicated to the candidate.

Type of Opening: Effective Date:

Chain-of-Command Approval

Hiring Supervisor (initiator), Director of Human Resources, Next Level(s) Manager(s) (if any), Applicable Member of President's Staff, Vice-President (Instruction and Student Services positions only) and President (regular positions only) who then forwards to the Director of Human Resources.

By clicking on the "Submit" button, the form will automatically be sent to the Director of Human Resources for processing.

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