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NAPA FORM TEMPLATE (1)

The North America Personnel Action Form is used to document various personnel actions such as new hires, terminations, and changes in employee information. It includes sections for personal details, job status, leave of absence, and termination reasons, along with signature approvals from the employee and the Language Centre Director. The form is designed to ensure proper record-keeping and compliance with HR policies.

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Olga Basharina
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36 views

NAPA FORM TEMPLATE (1)

The North America Personnel Action Form is used to document various personnel actions such as new hires, terminations, and changes in employee information. It includes sections for personal details, job status, leave of absence, and termination reasons, along with signature approvals from the employee and the Language Centre Director. The form is designed to ensure proper record-keeping and compliance with HR policies.

Uploaded by

Olga Basharina
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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North America Personnel Action Form

Effective Date of Change: 00/00/23


REASON FOR ACTION (Check All that Apply)
NEW HIRE Re-Hire OTHER OFF CYCLE ADJ. SPECIAL CHANGES TERMINATION
Instructor Instructor Transfer Adjustment PAYMENTS Department Voluntary
Administrative Administrative Leave of Absence Merit Incentive Location Involuntary
Specify: Specify: Maternity/Paternity Promotion Commission Title Reason:
Replacement Replacement ROE-Record of Other(specify): Status:
Addition Addition Employment Request Full-time
Temporary Temporary Reason: Part-time
Contract Contract Temp/Contract

Personal Information Change:


Name Change Address Change Other

EMPLOYEE INFORMATION
Mr. Last Name First Name S.I.N. # Date of Birth (m/d/y) Date of Hire (m/d/y)

Ms.
Mrs.

Home Address (Street, City, Province, Postal Code) Home Phone # Cell # Email Address

Gender Name of Emergency Contact Relationship: Emergency Contact #: Type:


Female
Male Home Work Cell Other:
_______________

Current Status Proposed Status (If applicable)


Dept. Name/Language Center Location & No. Dept. Name/Language Center Location & No.

Job Title Job Title

Annual/Hourly Rate Additional Rates Annual/Hourly Rate Additional Rates

Commission Formula Commission Formula

Work Schedule Language (Instructor) Work Schedule Language (Instructor)

Leave of Absence (Please Check All that Apply)


Short Term Disability Family Medical Leave of Absence Personal Leave of Absence Maternity/Paternity Worker’s Compensation

Leave From to Returned From Leave (Actual Date)


Termination (Please Check All that Apply)
Reason: Rating:
Would you Rehire? Yes No No. of Accrued, Unused Vacation Days:
Resignation* Excellent
Letter of Resignation Attached? Yes No No. of Severance Pay Weeks (if applicable):
Discharge* Above Standard
Reduction in Standard Was HR Involved In This Termination? Yes No
Notes:
Force Below Standard Employee Returned all Berlitz Materials? Yes No
Retirement Date Last Worked:
Death
*Reason:

Signature Approvals (Please sign if applicable)


Employee Date:

Language Centre Director Date:


Lorena Lathuillerie 00/00/23

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