HEALTH AFFAIRS FORM 4A*
NOTICE OF INTENT TO OFFER NONTENURE-TRACK PRACTICE
PLAN REAPPOINTMENT TO TITLES IN SECTIONS 1.83
AND 1.84(c), CHAPTER III, PART ONE, REGENTS’ R&R

 Name and Address                                                                 Date

MEMORANDUM OF APPOINTMENT, 20__ - ____ Fiscal Year

It is the intention of The University of Texas System to offer you an appointment to the following position for the indicated period.

Academic Title

Tenure Status

 

Nontenure-Track Clinical Appointment

Department

Period of Appointment

Percent Time

Budget Period

       

Base Compensation

Practice Plan Augmentation

Total Compensation

     

Your appointment to the above referenced position is dependent upon the approval of the Board of Regents of The University of Texas System. After approval by the Board of Regents, you will receive an official Memorandum of Appointment.

____________________________________
Chair of Department **

____________________________________
President

*NOTE: This form is not to precede an initial appointment to these titles. Use this form only to offer current appointees a reappointment. Health Affairs Form 4 is to be used for initial appointment and for reappointment.

** If the administrative unit does not have a Chair substitute the title of the head of the unit.

Last Updated:  April 21, 2000
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