Personnel Action Form
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ABBEVILLE COUNTY SCHOOL DISTRICT
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Personnel Action Form
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Employee NameEmployee ID
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Submitted byDate
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EMPLOYMENT ACTION
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ActionEffective DateRe-Hire DateEmployee TransferEffective Date
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New HireFrom Position
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Re-HireFrom Location
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ResignTo Position
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TerminationTo Location
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RetireAdd-On PositionEffective Date
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TERI StartNew PositionLocation
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TERI EndPrimary or Secondary
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Certificate Upgrade
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POSITION DETAILS
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FTEDaily Time InBreak OutBreak InTime Out
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Hours/DaySchedule
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Bus Driver/Monitor Route #
Does this employee work at multiple locations?
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Employee hired to replace
for the position
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Hourly/AnnualIf hourly, will (s)he submit time sheets for payment?
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Full Time/Part Time/Permanent/Temporary/Other
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As required by district hiring procedures, I have interviewed at least five applicants, including the person recommended.
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Applicants interviewed were1
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Principal/Dept Head SignatureDate
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DISTRICT OFFICE USE ONLY
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Human ResourcesFinance[ ]
Position Control
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Contract TypeSalary Schdle[ ]Professional Certified System
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Std Cont DaysAnnual Salary[ ]AESOP
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Curr Cont DaysFund #[ ]Budget Prep
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Certified DegreeAcct #[ ]
Sent to Payroll
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Pay StepNotes[ ]
Changed in Payroll
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Yrs. Experience[ ]
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PCS Code[ ]
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Human Resources Signature
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Superintendent Signature
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Finance Director Signature
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Transportation Director Signature
Revision Date10/27/2015
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