ELR Change Request


Request to Make Change to:
(increase, decrease & layoff)
Appointment Percentage
Reason for reduction in time:
(detail funding source and end date below)
Explain possible impact(s) of the action
​​​​​​​If yes, is the identified employee qualified for that position?
If yes, please identify the position(s) and explain.
​​​​​​​If yes, please describe how work will be distributed.
​​​​​​​If yes, please briefly describe the type of corrective action and the job performance problem.
 
Schedule
(Please enter in military time, example 08:00 or 18:30)
Employee’s Current Lunch Length
Employee’s Current Shift Length
What shift does the employee currently work?

Requested Shift
Requested Lunch Length
Requested Shift Length
(Please enter in military time, example 08:00 or 18:30)
(align with a pay period begin date)
Cost Center
Supervisor
Location
Position Description
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
Remote Work Arrangement
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
Change to Terms and Conditions of Employment
Download Form
One file only.
10 MB limit.
Allowed types: pdf, doc, docx.
One file only.
10 MB limit.
Allowed types: gif, jpg, png, pdf, doc, docx, xls, xlsx.