Form 105–047A

Rev. 09/18
page 1 of 2

Proposal for Adjunct Faculty Appointment

Division/Office: Date:

recommends (name) (EMPLID)

be appointed to the adjunct rank of for (semester) (year),

in the teaching area of at a salary of $ pay per teaching credit.

SUMMARY OF QUALIFICATIONS:
EDUCATION
Number of Semester Hours
Degree Year Major Field
in Teaching Field

TEACHING EXPERIENCE (FULL-TIME OR FULL-TIME EQUIVALENT):

Dates Employed
Field(s) Institution Number of Years and Months
(MO/YR–MO/YR)

RELATED OCCUPATIONAL EXPERIENCE (FULL-TIME OR FULL-TIME EQUIVALENT):

Dates Employed
Position Held Employer Number of Years and Months
(MO/YR–MO/YR)

This person is recommended for appointment in column: of the VCCS-29.

Director or Division Dean Date Campus Provost Date

(Division should list courses in the teaching field on Page 2)

 Form 105–047A
Rev. 09/18
page 2 of 2

Proposal for Adjunct Faculty Appointment

List courses identified as teaching field in chronological order below, listing only those required by the VCCS-29 for rank placement.
Quarter hours should be converted to semester hours. To find total of quarter hours, divide by three and multiply result by two or
divide the number of quarter hours by 1.5.

Name of Institution: Name of Institution:

Course Prefix and Course Name Semester Hours Course Prefix and Course Name Semester Hours

Total Semester Hours ____________

0 Total Semester Hours ____________
0