UW-PLATTEVILLE ACADEMIC STAFF
JOB SECURITY FORM
(Revised 10/96)
Directions: (Note: The Job Security Form does not need to be completed for employees who currently have a rolling horizon appointment unless the supervisor wishes to end the rolling horizon, change its length, or recommend an indefinite appointment.)
1. The “flow” of this form is: 1) Supervisor; 2) Area Head or Dean; 3) Academic Staff Personnel Commission; 4) Provost/Vice Chancellor or Assistant Chancellor; 5) Chancellor. After the 7th year, the supervisor MUST initiate the job security process. PLEASE NOTE: One person may be a Supervisor and an Area Head and an Assistant Chancellor. That person always signs as Supervisor. Thereafter the individual only signs at the highest level.
2. Persons recommending positive action should send the original form to the next level and send a copy to the employee. Persons recommending negative action should return the original form to the employee and send a copy to the Personnel Commission.
3. Certification by the employee’s supervisor that the employee has performed “as expected” or “above expectations” for at least five years is required for a multi-year or rolling horizon appointment. For an indefinite appointment, documentation of a previous multi-year appointment and demonstrated excellence in job performance and flexibility in education, experience, or professional development are required.
4. If you have any questions about this process or form, contact the Chair of the Academic Staff Personnel Commission.
EMPLOYEE INFORMATION: To be completed by employee’s supervisor and employee.
Employee Name:
Department(s):
Supervisor Name:
Employee Working Title(s):
Employee Unclassified Title(s):
This position is FTE for months per year. Including the current year, this employee has years of service as a member of the academic staff. If the employee is in the middle of a multi-year or rolling horizon appointment, indicate expiration date of current appointment: (month/year).
Employee Job Security History (e.g. has had one 2-yr. multi-year appointment 1996-1998):
SUPERVISOR RECOMMENDATION: Check all that apply.
______ This employee has had average or above average performance for at least five (5) years.
______ I recommend a multi-year appointment of ______ years through _____________ (month/year).
______ I recommend a rolling horizon appointment of ______ years through _____________ (month/year).
______ I recommend an indefinite appointment.
______ I recommend a one-year appointment.
Supervisor’s Comments (use additional pages if needed):

Supervisor’s Signature Required) ________________________________________
 
Date ___________________
 
Employee’s Signature Required) ________________________________________ Date ___________________
             I _____ agree _____ disagree with the supervisor’s recommendation.
Employee’s Comments (use additional pages if needed):

AREA HEAD OR DEAN RECOMMENDATION:
Please note: If you are both the Area Head and the Assistant Chancellor for this employee, do not sign here; sign only in the Assistant Chancellor area.
________ I endorse the supervisor’s recommendation.
________ I do not endorse the supervisor’s recommendation but instead recommend (check one):
  _____ a multi-year appointment of _____ years through ___________ (mo/yr).
  _____ a rolling-horizon appointment of ____ years through ___________ (mo/yr).
  _____ an indefinite appointment.
  _____ a one-year appointment.
Comments:

Signature _________________________________________________ Date ___________________
PERSONNEL COMMISSION RECOMMENDATION:
________ We endorse the Area Head or Dean’s recommendation.
________ We do not endorse the Area Head or Dean’s recommendation but instead recommend (check one):
  _____ a multi-year appointment of _____ years through ___________ (mo/yr).
  _____ a rolling-horizon appointment of ____ years through ___________ (mo/yr).
  _____ an indefinite appointment.
  _____ a one-year appointment.
Comments:

Signature _________________________________________________ Date ___________________
PROVOST/VICE CHANCELLOR OR ASST. CHANCELLOR RECOMMENDATION:
________ I endorse the Personnel Commission’s recommendation.
________ I do not endorse the Personnel Commission’s recommendation but instead recommend (check one):
  _____ a multi-year appointment of _____ years through ___________ (mo/yr).
  _____ a rolling-horizon appointment of ____ years through ___________ (mo/yr).
  _____ an indefinite appointment.
  _____ a one-year appointment.
Comments:

Signature _________________________________________________ Date ___________________
FINAL ACTION BY THE CHANCELLOR:
________ I endorse the Provost/Vice Chancellor or Asst. Chancellor’s recommendation.
________ I do not endorse the Provost/Vice Chancellor or Asst. Chancellor’s recommendation but instead recommend (check one):
  _____ a multi-year appointment of _____ years through ___________ (mo/yr).
  _____ a rolling-horizon appointment of ____ years through ___________ (mo/yr).
  _____ an indefinite appointment.
  _____ a one-year appointment.
Comments:

Signature _________________________________________________ Date ___________________
(Revised 10/96)


Address of this form: http://www.uwplatt.edu/asenate/pcsecform.htm
Return to the Personnel Forms Table of Contents
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Document last modified: February 11, 2005
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