Request for Service - LOA Hire /Change

Letters of Appointments (LOA) are part time employees of various types. The most common for SoM are: LOA - Part Time Instruction (PTI) Credit (Non-Clinical) LOA - Part Time Instruction (PTI) Not for Credit LOA - Administrative LOA - Hourly - Healthcare Practitioner and Technical LOA - One-Time Payment LOA - Temporary Faculty, Clinical For LOA Hire or Change Requests, Provide all Requested Information https://www.unlv.edu/medicine/hr

Requester Info

Complete the required information about the requesting person.(Requester info only at this section)

Requestor's First Name*

Requestor's Last Name*

Requestor's Phone Number*

Requester E-mail Address*

Requester Department*

Select

LOA Hire Information

Provide the required information about the LOA hire. Include the Type, Start and End Dates, Supervisor, Work Location, and Costing Allocation (Information only about the LOA hire in this section.)

LOA First Name*

LOA Last Name*

LOA's E-mail Address*

Type of LOA (Salary, Hourly, PTI)*

Select

Proposed Start Date*

Proposed End Date

Workday Access

Select or enter value

Supervisor*

Physical Location*

Select or enter value

Costing Allocation/Funding Source (PG or GR)*

Date Requested

Required Information for LOA Salaried, Clinical, Administrative, and Temporary Faculty only.

Information Required for LOA Salaried, Clinical, Administrative, and Temporary Faculty only in this Section. (NOT REQUIRED FOR PTI, OR ONE-TYPE PAYMENT)

Proposed Job Title

Level of Appointment

Select or enter value

FTE (percentage)

Salary Requested if 100% FTE

List of Duties (Please attach if needed)*

Required Information for PTI (Instructional/Non-Instructional)

Complete required information. PTI Instructional/Non-Instructional (Credit/Non-Credit ) only in this Section

Instructional/Non-Instructional

Select or enter value

# of Credits

Pay Rate

Course Description (Include course number)

One Time / One Type Payment Section

Complete the Required Information for One Time or One Type Payment. (Use this section for One Time or One Type payment only)

Total Amount of Payment

Rate Per Unit

Night Rate

Day Rate

Stand-By Rate

Additional information

Provide any additional information here.

Attachments required

Special Instructions for Attachment/s for LOA Hire/Change Request (review before submission or may cause delays) CV or Resume; Add all other information and uploads in the Additional Information field;

File Attachments

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