HomeMy WebLinkAboutPersonnel Action Request - GRISPERSONNEL ACTION REQUEST (PAR)
secti,01-1:1 —Core Efliployee Data (Current Data Required)
Empl#-, 2951 Legal Name: Delarosaj Velma Effective Date- lo
. a /OV21
section 2 — ERIP10yeeN Data (Required for New Hires
Separatiops, or. -If chall
Ttem
( 'lun ent Dat;a
Ivetv Dat�a
<Enter>
<Enter>
Name 0 Leg -it
Dolarosa, Vel hia
Address
Telephane
e
A,
0010-00-0000 -.00 /0.0/00
.SS#: 'Birthdate
SeCOOR 3 `Requested Action.
Acd n(•
Leave Dataarat,
eP ion Data
Position -Change - Promotion
A
Type
Reason
Start Date Oo/oO/. 0 0
A .
A
A
Stop Date 00/oo/bo
-Eligiblefor Rehire A
A Ve
sddi6li4 minb-hu
X iepffeka I.
Velmaha S-- ACep te I tl 8 Clin cal S -Sor f-Ot'W1Se'W1"thin Grant Inte
upem e
grat'd 8ervice-s,
pending BOCC approval. Her start date will be October 1, 20:21.
------- Core Renis (Current.Data Required)
ItemQ,0"r*eAt
Data New Dat -a
Dep t,#L-Dep- t
GrIS-Grant Mental H' r*e--lo 8 `IS -Grant Mene
eA.1thca 000 Gr tal Haltlicare-lo8000
J bb -4111 -Job Title
2rhercapist - -citlical 8upervisor
-1.50 54 15090 _Vvise
Hire — Poktio.n
08/11/14 - 1112-01V 08,11/ 4. 10/
Gr -Name T05--MiOra'Seiwices
py a Supervisor
ErAploy'ee' Typ�ie Part Time Rib g*ular Full Ti Miy
!�Ocfioh 6;—,8eq_'oh'd4r'yz'1teiAs (Rec if Chainjx;i
.1wre OUly
Itemt
Da
Cita
Curi- 11 , � I' . 4�
Me w a Dat
�. $6,389.07 Monthly
Base Wage
$5,'834.40 Monthly LR - Z,
Band / Step
13a / 7
14/ -5
Sty en
$90,0000 <Select Type>
$0.0.000o <Select. Type->
Pay Type./.,LSA
ExemDt (SALRYE)
Exempt (SALR
YE
(4Q rs/wk)
<Enter>
FTE
-.80 (32 hrs/wk)
ITTE—GrIS Only
<Enter>
Workweek
Standa.rd.. un -Sat
8tandard Sun �-S�s�t
SectiOn 7 - Authorizixig Signatures
Department: Date:
.
� t(yy.
Human Resources:Date:
V qui d Not eq- t'. red REa
Board Approvalffi
Chair: A
N
J,^
Vice -Chair: A/ Date:
Member:
Revised 05/2-5/202) 1