Skip to main content
Menu
Human Resources
Human Resources
Open Search
Search
Quick Links
+
UC Davis Health
UCPath
UC Learning Center
AggieService
Cognos Reporting
PPM
PPSM
PeopleAdmin
TAM (UC Davis)
TAM (UC Davis Health)
Time Reporting System
Ecotime
Staff Directory
Employment Verification
Main navigation
Careers
Prospective Employees
Careers at UC Davis
Browse Available Jobs
Returning Applicants
Nurse Recruitment
Temporary Employment
Benefits Overview
Campuses & Communities
Employee Resources
Flex / Remote Work
UCDH Digital Workplace Program
Davis Campus Flexible Work
Building a Flexible Workplace
Employee Support
Staff Emergency Funds
Academic & Staff Assistance Program
Center for Advocacy, Resources & Education (CARE)
Leading Through Uncertainty
Ombuds Office
Benefits
Open Enrollment
Medical Plan Rates
Health & Welfare
Post Doc Scholar Benefits
Presentations
Retirement & Savings
Publications
FAQs
Health Care Facilitator Program
Career Development
Compensation
Career Tracks
Salary Scales
2022 Salary Program for Non-Represented Staff
FAQs
Disability Management Services
Diversity & Inclusion
Best Employer for Diversity and Women
Resources for Trans and Non-Binary Employees
Learning and Development
New Employees
Performance Appraisals
Annual Employee Performance Appraisals
Experience Conversations Toolkit
Probationary Evaluations for Staff
Time Reporting
Ecotime (UC Davis Health)
TRS (UC Davis)
UC Davis Health Resident Program
WorkLife
Events
Lactation Support
Wellness Resources
Workplace Flexibility
AggieService
Supervisor Resources
Flex / Remote Work
UCDH Digital Workplace Program
Davis Campus Flexible Work
Building a Flexible Workplace
Compensation
Classification
Equity Adjustment
Labor Market Analysis
2022 Salary Program for Non-Represented Staff
Data and Dashboards
Disability Management Services
Diversity & Inclusion
Best Employer for Diversity and Women
Race Matters
Recruiting Diverse Talent
Resources for Trans and Non-Binary Employees
Executive & Leadership Recruitment
Learning and Development
Leave/Time-Off
Talent Acquisition
UC Davis
UC Davis Health
Temporary Employment Services (TES)
FAQs
Onboarding Toolkit
Performance Management
Annual Employee Performance Appraisals
Corrective Action
Probationary Evaluations for Staff
Sample Letters to Employees
WorkLife
HR Depts.
Academic & Staff Assistance Program
Benefits
Compensation
Disability Management Services
Employee & Labor Relations
Davis Campus
UC Davis Health
Executive Programs and Recruitment
HR Business Partners
Learning and Development
Career Development
Organizational Excellence
Records
Shared Services Organization
Talent Acquisition
Workforce Strategies
Exit Survey
Staff Experience
WorkLife
Workplace Violence Prevention
Forms
Contact
Staff Directory
Organizational Chart (Interim)
Our Locations
Service Channels
ELR Change Request
Breadcrumb
Home
ELR Change Request
Your Name
Your Email
Employee Name
Employee Email
Position Number
Job Code
Bargaining Unit
- Select -
87: Stipend/Differential Pay
99: Non-represented (PPSM)
A3: Non-represented (Academic Senate)
BX: UAW (Academic Student Employees)
CX: Teamsters (Clerical)
DX: UAPD (Physicians)
EX: AFSCME (Patient Care Technical)
F3: IAFF (Firefighters)
FX: Non-represented (Research and Allied Professionals)
GS: Printing Trades
HX: UPTE (Health Care Professionals)
IX: UC-AFT (Non-Senate Instructional)
K3: Non-represented (Skilled Crafts)
LX: UC-AFT (Professional Librarians)
M3: CIR SEIU (Committee of Interns and Residents, SEIU)
NX: CNA (Registered Nurses)
PA: FUPOA (Police)
PX: UAW (Postdoctoral Scholars)
RA: UAW Academic Researchers
RX: UPTE (Research Support Professionals)
SX: AFSCME (Service Unit)
TX: UPTE (Technical Unit)
X: Post Doctoral Scholars
Z3: Readers & Tutors
Appointment Type
- Select -
Career
Contract
Partial Year Career
Per Diem
Rehire Retiree
STE / Limited
Supervisor Name
Supervisor Email
Request to Make Change to:
Appointment Percentage
(increase, decrease & layoff)
Schedule
Cost Center
Supervisor
Location
Position Description
Remote Work Arrangement
Terms and Conditions of Employment
Appointment Percentage
Current FTE
Requested FTE
Date you want the FTE change to be effective:
Reason for reduction in time:
Lack of funds
Lack of Work
Operational Demands
Budgetary
Reorganization
Anticipated due to expiration of funding
(detail funding source and end date below)
Explanation of the action
Is this a voluntary change? If voluntary, please describe in comment box below.
Yes
No
Explain possible impact(s) of the action
Will another position be created at a different classification or salary level as a result of this action?
If yes, is the identified employee qualified for that position?
Will the proposed action result in any reclassification proposals for other positions in the position closure unit?
If yes, please identify the position(s) and explain.
Will the work of any of the identified employees be reassigned to another employee?
If yes, please describe how work will be distributed.
Did the identified employee receive any corrective action or counseling for job performance problems during the past two years?
If yes, please briefly describe the type of corrective action and the job performance problem.
Is the employee a member of a protected group for which there is a current affirmative action goal?
Schedule
Employee’s Current Start Time
(Please enter in military time, example 08:00 or 18:30)
Employee’s Current Lunch Length
30 minutes
60 minutes
Employee’s Current Shift Length
4 hours
6 hours
8 hours
9 hours
10 hours
12 hours
What shift does the employee currently work?
Day Shift
Evening Shift
Night Shift
Requested Shift
Day Shift
Evening Shift
Night Shift
Requested Lunch Length
30 minutes
60 minutes
Requested Shift Length
4 hours
6 hours
8 hours
9 hours
10 hours
12 hours
Requested Start Time
(Please enter in military time, example 08:00 or 18:30)
Requested New Schedule Effective Date:
(align with a pay period begin date)
Summary of the changes
Is this a new employee to the University?
Yes
No
Is this employee new to your department due to an internal UCDH transfer or due to recruitment efforts?
Yes
No
Is this employee changing shifts due to internal bidding within your department?
Yes
No
Are you attempting to correct an employee’s hours on Ecotime to reflect the hours that the employee is currently working?
Yes
No
Cost Center
Current Cost Center
Requested Cost Center
Requested effective date of the cost center change
Reason for the change in cost center
Will the change have seniority or layoff implications? If so, describe in comment box below.
Yes
No
Supervisor
Name of the new supervisor
Requested effective date of the supervisor change
Reason for the change in supervisor
Will the change have seniority or layoff implications? If so, describe in comment box below.
Yes
No
Location
Current Location
Requested location
Requested effective date of the location change
Reason for the change in location
Position Description
Upload current position description
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
Upload proposed position description
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
Summary of the changes
Reason for the change in position description
Remote Work Arrangement
Type of remote worker
Remote
Employees who work from home or an alternate location full time (4 or more days per week).
Hybrid
Employees who spend part of their week (appx. 2-3 days per week) working from locations other than the office.
On-Site
Employees who work onsite 4 or more days per week.
Number of days per week will you work in-person at the office
2
3
Number of days per week will you work in-person at the office
0
1
Number of days per week will you work in-person on site
4
5
What day(s) of the week will you work in-person at the office (days selected below must match count of days requested above)
Monday
Tuesday
Wednesday
Thursday
Friday
What day(s) of the week will you work in-person at the office (days selected below must match count of days requested above)
Monday
Tuesday
Wednesday
Thursday
Friday
Upload signed Remote Work Agreement
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
Upload signed Performance Plan
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
Upload Current Position Description
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
Change to Terms and Conditions of Employment
Upload Notice of Intent to Change Terms and Conditions of Employment Form
Download Form
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
Please Describe
Upload Attachment
One file only.
10 MB limit.
Allowed types: gif, jpg, png, pdf, doc, docx, xls, xlsx.
Describe Comment / Summary of the changes
Upload Attachment
One file only.
10 MB limit.
Allowed types: gif, jpg, png, pdf, doc, docx, xls, xlsx.
Upload Attachment
One file only.
10 MB limit.
Allowed types: gif, jpg, png, pdf, doc, docx, xls, xlsx.
Upload Attachment
One file only.
10 MB limit.
Allowed types: gif, jpg, png, pdf, doc, docx, xls, xlsx.
Status message
Please note this form is not intended for use with any protected health information (PHI) including physician notes, medical documents or diagnosis information. Employee and Labor Relations does not intercept these types of documents, If you wish to speak with someone about this, please call (916) 734-3362 for assistance.
Leave this field blank