Is the employee’s statement of additional duties complete and correct? Yes
No
If no, please use the space below to amplify or correct the employee’s statement.
Please indicate your perception of the employee’s request.
Position is correctly classified
Position is over-classified
Position should be raised to a higher job level
No opinion
Date ___/___/_____
Supervisor’s Signature ___________________________________________________________________
Please type or print:
Name _________________________________________________________________________________
Title ______________________________________________________
Phone (
)
-
Department ____________________________________________________________________________
Campus Mailing Address _________________________________________________________________
Date ___/___/_____
Department Head’s Signature _______________________________________________________________
Please type or print:
Name _________________________________________________________________________________
Title ______________________________________________________
Phone (
)
-
Department ____________________________________________________________________________
Campus Mailing Address _________________________________________________________________
Date ___/___/_____
Dean’s Signature ________________________________________________________________________
Please type or print:
Name _________________________________________________________________________________
Title ______________________________________________________
Phone (
)
-
Department ____________________________________________________________________________
Campus Mailing Address _________________________________________________________________