EMPLOYEE CHANGE FORM ("C")

INSTRUCTIONS:

Hiring Supervisor:

1. Complete Sections 1 & 2.

2. Check "Ready to submit to Supervising Admin?" box, and click "Submit" button (at bottom of form).

Supervising Administrator:

1. Complete Section 3.

2. Check "Supervising Admin. ready to submit?" box, and click "Submit" button (at bottom of form).

Human Resources:

1. Complete Section 4.

2. Check "HR ready to submit?" box, and click "Submit" button (at bottom of form).

President:

1. Complete Section 5.

2. Check "Ready to Submit" box, and click "Submit" button (at bottom of form).

Section 1: Person Completing the Form-Information

Request Date: * +

Effective Date: * +

Employee's Name: *

Employee lD:

Employee's Email: *

Section 2: Change Information

Employee's Name *

Current Title *

New Title *

Current Classification *

New Classification

Current Employment Status *

New Employment Status

Current houly rate or salary? *

New hourly rate or salary?

Current Work Schedule (Hours/Days/Months)

New Work Schedule (Hours/Days/Months)

Budget/Funding Source

SRC Funds

Grant/External Funds

SRC Funds Amount

Grant/External Funds Amount

Change Reason

Supervisor Name:

Supervisor Email Address

Supervising Administrator Name

Supervising Administrator Email

Ready to submit to Supervising Administrator?

Yep!

Questions about this form? Contact Andrea Thomson.

Section 3: Supervising Administrator Approval

Supervising Adminstrator Name

Approved

Rejected

Date +

Comments

Supervising Admin ready to submit?

Yep!

Questions about this form? Contact Andrea Thomson.

Section 4: Human Resources Approval

Human Resources Name

Approved

Rejected

Date +

Comments

HR ready to submit?

Yep!

Questions about this form? Contact Andrea Thomson.

Section 5: President Approval (cc: Payroll, Hiring Supervisor)

Approved

Rejected

Date +

Comments

Ready to submit?

Yep!

Questions about this form? Contact Andrea Thomson.

Human Resources Office Use Only

Benefit worksheet update

Completed

N/A

Copy of "C" form to Executive Committee (bargaining unit positions only)

Completed

N/A

Employee info into administrative system

Completed

N/A

Evaluation schedule update

Completed

N/A

Organization chart update

Completed

N/A

Salary log update

Completed

N/A