Forms

Faculty Appointments

Form

Revision Date

Format
AP 101: Academic Appointment and Assignment Record March 2015 MS Word
AP 107-A: Administrative Time June 2011 MS Word

AP 107-B: Assigned Time

Resource: CSU Assigned Time Code Definitions

January 2018

MS Word

AP 107-C: Other Support Time

Resource: FY Replacement Funding Chart

July 2017

September 2021

MS Word

PDF

AP 310: Research Quarter Request January 2018 MS Word

Assigned Time for Exceptional Levels of Service to Students Request 2021-22

Resource: AT for Exceptional Levels of Service to Students Policy Statement

March 2021 MS Word

Academic Student Appointments

Form

RevisioN Date

Format

ASE 101: Academic Student Employee Description of Duties

Resource: State Student Classification Descriptions

November 2020

MS Word

ISA 101 2021/2022: Instructional Student Assistant Appointment Record

Resources: ISA Hourly WorksheetExecutive Order 1083 - Limited Reporter Acknowledgement

August 2021

Adobe Sign

AP 101: Academic Appointment and Assignment Record

Note: Use for Graduate Assistant appointments.

March 2015

MS Word

Additional Assignments and Pay

Form

Revision Date

Format
SC 100: Special Consultant Appointment and Agreement Form March 2021 PDF

SC 101: Special Consultant Pay Request

October 2017

Excel

AP 131: Faculty Service Payment Request Form

Note: No payments will be processed in the month of November, including any AP 131 forms received after October 5th.

February 2020

MS Word

Substitute Instructional Faculty (2356) Payment Request Form February 2021 PDF

Evaluations

Form

Revision Date

Format

AP 109 DPRC - For Performance Evaluations

Guide: Routing AP 109 DPRC Form via AdobeSign

Guide: Removing Security from AdobeSigned AP 109 Prior to Uploading to Interfolio

September 2021

MS Word

AP 109 DPRC - For Periodic Evaluations

Guide: Routing AP 109 DPRC Form via AdobeSign

Guide: Removing Security from AdobeSigned AP 109 Prior to Uploading to Interfolio

September 2021 MS Word
AP 109 DH/DC - For Performance Evaluations September 2021 MS Word
AP 109 DH/DC - For Periodic Evaluations September 2021 MS Word
AP 109 CPRC - For Performance Evaluations September 2021 MS Word

AP 109-L DPRC: Temporary Faculty Evaluation Form for Department Peer Review Committees

Guide: Routing AP 109 DPRC Form via AdobeSign

Guide: Removing Security from AdobeSigned AP 109 Prior to Uploading to Interfolio

Coming Soon

MS Word

AP 109-L DH/DC: Temporary Faculty Evaluation Form for Department Heads/Chairs

Guide: Removing Security from AdobeSigned AP 109 Prior to Uploading to Interfolio

Coming Soon MS Word

Leaves

Form

Revision Date

Format
AP 112: Leave with Pay Application Form September 2021 MS Word
AP 112-B: Leave with Pay Agreement

February 2021

PDF

AP 112-C: Leave with Pay Promissory Note

February 2021

PDF

AP 190: Faculty Request for Leave of Absence Without Pay August 2021 MS Word

AP 193: Parental Leave Options Form

Reference: Faculty Parental Leave Contract Provisions

August 2021 MS Word

AP 2020: Voluntary Reduction in Time Base (VRTB) Sample for 2021-22

Please contact your college administrator to complete

July 2021 PDF

Recruitment

Form

Revision Date

Format
On-list Reference & Employment Check Form November 2021 PDF
Advancing Faculty Diversity Cluster Hire Search Proposal May 2018 MS Word

Separation & Retirement/FERP

Form

Revision Date

Format
AP 191: Faculty Notice of Resignation September 2020 PDF
AP 191: Faculty Notice of Resignation September 2020 AdobeSign

AP 140: Pre-retirement Reduction in Time-Base (PRTB) Election Form

January 2021

MS Word

AP 154: Faculty Early Retirement Program (FERP) Election Form

January 2021 MS Word
AP 155: Faculty Early Retirement Program (FERP) Reduction Request for 2021-22 January 2021 MS Word
AP 156: Faculty Early Retirement Program (FERP) Redistribution Request for 2021-22 January 2021 MS Word

Separation and Retirement Forms

Note: Including Form PR 192: Early/Final Settlement Authorization

 

Website

Miscellaneous

Form

Revision Date

Format
AP 312: Application for Market Increase August 2021 MS Word
Outside Employment Disclosure Form - Faculty

 

MS Word
Outside Employment Disclosure Form - MPP  

PDF

HR Forms   Website

 

Related Content

Calendars

calendar

Click the link for registrar, payroll, work schedule, LWP, periodic evaluation, RPT, documentation and payment calendars.

Important Dates

Summer Term

Baker Science Building

Summer Eligibility Lists, Instruction, and Forms

Summer Term Info

H-1B Visas

Information on applying for an H-1B Visa.

Get Answers Here

Interfolio

Visit this page to access Interfolio resources, instructional guides and training dates. For assistance submitting your electronic Working Personnel Action File (WPAF) for a performance or periodic evaluation.

More Information

Cluster Hire

Cal Poly strongly values diversity and inclusion, especially in the classroom and among its areas of study. To promote inclusive teaching strategies across the university and increase curricular coverage of areas related to diversity and inclusion, a university-wide cluster of tenure-track faculty search was launched.

Meet The New Faculty