Grant Personnel Change Form
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1Grant Personnel
Change Form
Requesting Org.: _______________________
Effective Date: _____________________________
Name: ________________________________
Email:_____________________________________
□ CURRENT PERSONNEL
Grant #: ____________________________
Name: ___________________________________
Org. #: _____________________________
Org. Name: _______________________________
Role: ______________________________
Email: ____________________________________
□ NEW PERSONNEL
Grant #: ____________________________
Name: ___________________________________
Org. #: _____________________________
Org. Name: _______________________________
Role: ______________________________
Email: ____________________________________
□ STATUS CHANGE
Previous Status (Choose One from each Column):
□
□
□
□
Full-Time
Temporary
Exempt
Benefit Eligible
□
□
□
□
Part-Time
Permanent
Non-Exempt
Non- Benefit Eligible
New Status (Choose One from each Column):
□
□
□
□
Full-Time
Temporary
Exempt
Benefit Eligible
□
□
□
□
Part-Time
Permanent
Non-Exempt
Non- Benefit Eligible
□ POSITION FUNDING
Current Rate of Pay:
New Rate of Pay:
$______________ □ Hourly □ Salary
$______________ □ Hourly □ Salary
Funding Source(s):
Funding Sources must equal 100%
__________________________________________
%________
__________________________________________
%________
__________________________________________
%________
□
TERMINATION (if applicable)
Position Code: ___________________ Eligible For Rehire: □ YES □
NO
Authorization Signatures:
Budget Manager: ___________________________________
Date: ____________
Date: ____________
Department Chair: __________________________________
Date: ____________
Dean: ____________________________________________
Grants Administrator
Date: ____________
________________________________
:
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Parent category: Business