APPENDIX L-1

Contra Costa Community College District                 Faculty Service Area Assignment Documentation

Name         ____________________________                                 Check One: □    New Employee

College       ____________________________                                                       □    Current Employee adding an FSA

Bases for Determining FSA Assignment

Minimum Qualifications Discipline Satisfied Via:

                  _____________________________________________________________________

                  _____________________________________________________________________

Competency For Discipline Satisfied Via:

□    Has taught at least one semester/quarter credit course during two different semesters/quarters at an accredited college/university in the discipline of the FSA; or has performed the duties at least 20% of the hours per week indicated for a full load in assignments described in Article 7 of the District/United Faculty Agreement.

□    Has completed the equivalent of 15 semester units of upper division and/or graduate level course work in the discipline.

□    Possesses a valid credential in a specific subject matter; i.e., is eligible to teach those subjects listed on the credential or in the “GUIDE TO SUBJECT MATTER AREAS FOR COMMUNITY COLLEGE CREDENTIALS,” September 1974 (or subsequent revision), and any certificate or license required in the discipline.

□    In a vocational area has the combination of degree and work experience as stipulated in the Disciplines List, and submits evidence of occupational proficiency based upon at least two years of recent work experience, calculated either consecutively or cumulatively, which is directly related to the occupation to be taught or upon evidence of equivalent proficiency.

FSA Assignment: _________________________________________________________________

College Review Team:

                                      ______________________________________________                                                    ____________________________

                                                                                          Signature                                                                                                                                                Date

                                      ______________________________________________                                                    ____________________________

                                                                                          Signature                                                                                                                                                 Date

                                      ______________________________________________                                                    ____________________________

                                                                                            Signature                                                                                                                                                Date

DISTRICT OFFICE USE

□             Governing Board Approval                                                                                 Date:                                    

□             Notification to faculty                                                                                          Date:                                    

□             PFSA Screen Verified                                                                                           Date:                                    

□             Copy of PFSA Screen and 4cd-154 form to Personnel File                           Date:                                    

4cd-154 (Rev. 2/92)