Staff Action Form
Caldwell County Schools
Name of Employee
*
First Name
Last Name
School/Location of Position
*
Employee Number (If Available)
Position Title
*
Staff Action Type
*
Location Change
Budget Code Change
Additional Assignment
Stipend
Salary Change
Change in Hours
Change in Assignment
New Hire (only if not posted in TeacherMatch)
Other
Months in Employment
*
10
11
12
Other
Hours of Employment (per day)
Anticipated Effective Date (pending HR approval, please do not start without verification)
*
-
Month
-
Day
Year
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Describe the staff action you are requesting:
*
The following special conditions apply to this employment:
Funding Source
Please upload any pertinent information (transcripts, diploma, etc).
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of
I declare that neither I nor the Assistant Principal(s) of this school is related to the person recommended in any manner as specified by Board of Education Policy.
Principal/Director
*
First Name
Last Name
Principal/Director Email (for your confirmation)
*
Date
-
Month
-
Day
Year
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Signature
*
Submit
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