Staff (SHRA) Employee Request for Approval to Engage in Outside Work

Policy 604.5

Policy and Procedure Statements

Approval Procedure - Request to Engage in Outside Work

4.1.1 The purpose of this approval procedure is to determine that the outside work does not have an adverse effect on the primary employment with the University and does not create a conflict of interest.

__________________________________ is requesting approval to engage in outside work .

1) Nature and place of work:

2) Amount of time to be devoted to the work (length to time to be employed and specific hours of work):

Approval ____________________________ date_____________ Immediate Supervisor

____________________________ date_____________ Dean/Dept. Chairperson

(Copy of completed form should be sent to the Office of Human Resources for inclusion in employee's personnel file.)