1. THE UNIVERSITY OF NORTH CAROLINA AT CHARLOTTE

   QUESTIONNAIRE TO SOLICIT PERTINENT INFORMATION NEEDED TO BEGIN THE PROCESS OF HIRING AN EMPLOYEE IN SUPPORT OF PROGRAMS/PROJECTS FUNDED BY GRANT AND/OR CONTRACT

   (Prepare a separate questionnaire for each employee to be hired.)

   Proposal Number:
   Date questionnaire completed:	Date revised:
   Program/Project Director:
   Department/Office:	Telephone:
   1. What is the name (title) of the program/project?
   2. What is the source of funding for the program/project?
   3. What is the estimated duration of the program/project (in terms of funding)?      From:      To:
   4. Is program/project subject to being renewed? Yes ? No ?
   5. What will be the "working title" of the employee you hire?
   6. How long will this employee be needed to work? Less than six months Six months or more but less than nine months Nine months or more but less than one year (12 months) One year (12 months) or more
   7. How many hours a week will the employee be expected to work? 19 or less hours per week 20 or more but less than 30 hours per week 30 or more hours per week Will vary from week to week but will work no more than 988 hours in a calendar year Will vary from week to week and will work more than 988 hours in a calendar year
   8. How do you expect the employee to be compensated? Based on the number of hours worked as determined from a time card Salary No expectation
   9. What benefits do you expect the employee to receive? Vacation and Sick Leave Medical Insurance Participation in Retirement Program No Benefits No expectation
   10. What do you expect the employment category of the employee to be? Temporary employee Classified (SPA) employee Exempt (EPA) employee EPA Staff Special Faculty No expectation
   11. Do you have an expectation as to the salary/hourly rate the employee will be paid? Yes If so, how much: $ _________________ per ___________________ This expectation is based on: ___________________________________________________________________ No
   12. Do you have a particular individual in mind for this position? No Yes If so, what is the name and current work status of the individual _________________________________________________________________
   13. Briefly described expected duties of employee:
   ADDITIONAL NOTES:

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