NATIONAL BOARD SUPPLEMENT (NBS): TOTAL SALARY + NBS: TOTAL INCREMENT: TOTAL SALARY : NOTE: National Board Certification Supplement (NBS) applicable to WVDE Coordinator level only. OLD ACCOUNT INFORMATION (Transfer/Reclassification) Position Title: Position No.: Division: Office: Fund Approp. Program FTE PPC Base Salary Annual Increment Sub Total Salary Unit NATIONAL BOARD SUPPLEMENT (NBS): TOTAL SALARY + NBS: TOTAL INCREMENT: TOTAL SALARY : ATTACHMENTS: (Please check those that apply.) Employment Application for New Employment Physician’s Statement for Request for Medical Leave County Salary Schedule Information and Computations/OIEP Copy of Certification License (New Employment/Salary Documentation of Salary Supplement Advancement) Letter Requesting Leave (Personal, Medical, etc.) Background Information Other Retirement/Resignation Letter Explain Other: CHECKLIST FOR OFFICE OF HUMAN RESOURCES References Checked by Executive Director Offer Letter/Salary/Starting Date Mailed Background Check PROCESS FOR SIGNATURES Executive Director/Chief Officer/OIEP HR Executive Director Chief Financial Officer/Payroll Supervisor Chief of Staff/Deputy Superintendent/State Superintendent Originator Date Chief Officer/OIEP Date Chief Financial Officer Date Payroll Supervisor Date HR Executive Director Date Chief of Staff/Deputy Superintendent/State Superintendent Date
NATIONAL BOARD SUPPLEMENT (NBS): TOTAL SALARY + NBS: TOTAL INCREMENT: TOTAL SALARY : NOTE: National Board Certification Supplement (NBS) applicable to WVDE Coordinator level only. OLD ACCOUNT INFORMATION (Transfer/Reclassification) Position Title: Position No.: Division: Office: Fund Approp. Unit Program FTE PPC Base Salary Annual Increment Sub Total Salary NATIONAL BOARD SUPPLEMENT (NBS): TOTAL SALARY + NBS: TOTAL INCREMENT: TOTAL SALARY : ATTACHMENTS: (Please check those that apply.) Employment Application for New Employment County Salary Schedule Information and Computations/OIEP Documentation of Salary Supplement Letter Requesting Leave (Personal, Medical, etc.) Other Physician’s Statement for Request for Medical Leave Copy of Certification License (New Employment/Salary Advancement) Background Information Retirement/Resignation Letter Explain Other: CHECKLIST FOR OFFICE OF HUMAN RESOURCES References Checked by Executive Director Background Check Offer Letter/Salary/Starting Date Mailed PROCESS FOR SIGNATURES Executive Director/Chief Officer/OIEP Chief Financial Officer/Payroll Supervisor HR Executive Director Chief of Staff/Deputy Superintendent/State Superintendent Originator Date Chief Officer/OIEP Date Chief Financial Officer Date Payroll Supervisor Date HR Executive Director Date Chief of Staff/Deputy Superintendent/State Superintendent Date