Rutgers Biomedical and Health Sciences
Secondary Assignment Request for Faculty
Initial Secondary Assignment Request for Reappointment
Faculty Member’s Last/First Name, Degree:
Employee ID:
PRIMARY
SECONDARY
School:
School:
Department/Division:
Department/Division:
Academic Title:
Academic Title:
FTE:
FTE:
Location/Campus:
Location/Campus:
Duties:
If Teaching:
Course Title: Course Credits:
Hours of the Day:
Days of the Week:
Payment Terms
Hourly Rate:
Per Credit Rate:
Lump Sum Rate:
Term of Assignment:
REQUIRED APPROVALS
Requesting Department Administrator/Chair: Date:
Requesting Principal Investigator/Project Director (if applicable): Date:
Requesting School Dean: Date:
Home Department Chair or other Direct Supervisor: Date:
Home School Dean: Date:
Unit: Division: Org: Project #: Bus. Line: Percent : Amount:
Unit: Org: Project #: Bus. Li
ne:
Percent: Amount:
Division:
Fiscal Officer Approval:
Date:
Director, RBHS Faculty Affairs: Date:
Payment Type: Time & Labor
Secondary Assignment
(Contact Primary School T&L Preparer) (Submit Secondary Assignment FTF for UHR)
Revised: 12/17/2020
