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
Type of remote worker
Employees who work from home or an alternate location full time (4 or more days per week).
Employees who spend part of their week (appx. 2-3 days per week) working from locations other than the office.
Number of days per week will you work in-person at the office
Number of days per week will you work in-person at the office
What day(s) of the week will you work in-person at the office (days selected below must match count of days requested above)
What day(s) of the week will you work in-person at the office (days selected below must match count of days requested above)
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.