EMPLOYMENT CHECKLIST

NOTE:  All information and materials which are applicable to the employment of this individual must accompany this completed checklist to the Human Resources Office before final approval for employment will be given.  Must have all appropriate signatures within your Department or Division prior to submission to the Human Resources Office.  No offers of employment or salary can be made until all approvals are documented.

Full-Time Employment Recommendation

1.  Name of Candidate being Recommended:

2.  Position Title:

3.  Department or Office:

4.  Effective Date of Employment:

Initiator: _________________________________________	Date:
Exec. Dir./Vice President: ____________________________	Date:

Please attach screening logs, interview logs, Telephone Reference Check records and the application of the person who is being recommended for the position in addition to these three pages.                       DO NOT WRITE BELOW THIS LINE

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TO BE COMPLETED BY HUMAN RESOURCES OFFICE:
5.  Highest Degree Held: _____________________	Additional Hours Beyond Degree: _______________
6.  Total Years of Related Work Experience: ______	Teaching Experience : ________________________
7.  Recommended Salary: _____________________	Based on Salary Guideline: ____________________
8.  Contract days: __________________________	Notes: ____________________________________
9.  New Position or Replacement position for __________________________________________

EEO/Affirmative Action Officer ______________________________	Date: _______________________
Exec. Director, Human Resources _____________________________	Date: _______________________
President _______________________________________________	Date: _______________________

List all applicants interviewed for this position and rank the top candidates in order of preference. In the space provided for each candidate, explain why the candidate was so ranked, according to the requirements stated on the job description. If more than eight candidates were interviewed, please attach additional sheets. LIMIT YOUR COMMENTS TO THREE LINES.
NAME	GENDER	ETHNIC ORIGIN	APPARENT PHYSICAL HANDICAP	HIGHEST DEGREE	YRS. RELATED EXPERIENCE
	Male Female	White Hispanic Black Asian Am. Indian
	Male Female	White Hispanic Black Asian Am. Indian
	Male Female	White Hispanic Black Asian Am. Indian
	Male Female	White Hispanic Black Asian Am. Indian
	Male Female	White Hispanic Black Asian Am. Indian
	Male Female	White Hispanic Black Asian Am. Indian
	Male Female	White Hispanic Black Asian Am. Indian
	Male Female	White Hispanic Black Asian Am. Indian

CANDIDATE SELECTION PROCEDURE NOTE: These pages must be completed and returned along with the recommendation checklist. This information is necessary for reviewing the selection procedure to assure that equal opportunity was afforded to all qualified applicants prior to preparing the recommendation for Board approval.
1.	In addition to the minimum qualifications as stated on the job description, what selection criteria was established to determine which applicants would be interviewed and/or recommended for this position.
Limit your response to 15 lines.
2.	Briefly describe the procedure used to select the candidate being recommended from the total pool of applicants.
Limit your response to 15 lines.
3.	Attach the screening logs, interview logs, telephone reference check records and the application of recommended candidate in addition to these three pages.

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