Temporary Employment Change Form Header Image

Temporary Employment Change Form


This online form is intended for managers to make corrections to a previously submitted authorization form, or make changes effective after the start date, for a Temporary Employee.  It should be completed prior to the date of the change whenever possible.


If you have any problems/questions, please contact Anna Cuéllar-Parajón x4075.

Employment Details

Employee Name*
Effective Date of Change*

New Position Details


INSTRUCTIONS: Please only fill in items below which have changed from a prior authorization request.

Supervisor
Those working on campus will be required to submit proof of vaccination and complete regular testing. They will be issued an ID card for this purpose.
Remote Work Location
Pay Options
First Day of Work
This must be at least 7 days in the future.
Last Day of Work
This should be no later than 6/30 of the current fiscal year.

Accounting Details - Account Code #1

Accounting Details - Account Code #2 (optional)

Authorization Details

A copy of this form will be automatically CC'ed to you.