Request Form For Civil Service Personnel
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1CIVIL SERVICE PERSONNEL REQUEST FORM
A
1. APPLICATION is hereby made for the appointment of one
(indicate Civil Service classification title)
in the
Work Department, salary to be paid from
Budget Name and No.
Position No.
UCS No.
2. THIS IS A REQUEST FOR: (Check the appropriate boxes)
Replacement of
who will: ___be on paid leave,
___be on unpaid leave,
___transfer/promote, ___retire*, or ___terminate employment* on ____________. (Attach signed/dated job description)
*Resignation form must be completed by employee prior to filling vacancy.
New position.
(Attach signed/dated job description)
Change in classification while position is vacant to better serve departmental needs. (Attach signed/dated job description)
Change in budget effective ________________________.
Reclassification/reallocation for _____________________________ from________________________________.
(employee name)
(present classification)
Temporary upgrade for _______________________________ from ________________ through ______________.
(employee name)
(date)
(date)
Change in percent of appointment from ________% to ________% , effective ___________________.
Reassignment from ___________________________ to _____________________________________.
Extra help (not to exceed 900 work hours) for ______________________ from ___________ through ________________.
(employee name, if known)
(date)
(date)
Other
_____________________________________________________________________________________________.
3. THIS EMPLOYMENT WILL BE:
12 months
Less than 12 months ______________________(indicate number of months)
8 a.m. – 4:30 p.m., Mon-Fri
Other ________________________________________ , ________ % of appointment
4. POSITION SPECIFICS: Building _______________________ Room ___________ Phone _________________ Ext ______
WIU on-line campus directory department _____________________________ Supervisor of position _____________________
5. REQUEST SUBMITTED BY _________________________________________________ Date _________________________
ROUTE IN THIS ORDER FOR SIGNATURE APPROVALS:
A. Dean /Director _______________________________________________________________ Date _________________________
B. Supervising Vice President _____________________________________________________ Date ________________________
C. President (for new positions only) _______________________________________________ Date _________________________
D. Budget Office________________________________________________________________Date ________________________
E. Human Resources Department: Date received ________________________ Log No. ______________ TC copied ____________
1. Employment:
2. Classification:
3. Examination:
4. Employment:
Date received ________________ Date received ________________ Date received ___________
Date received ____________
Comment ___________________ Job description date ___________ Last test date ___________
Dept contacted___________
___________________________ Last audit date _______________ Close Date _____________
Freeze date ______________
___________________________
___________________________ ______________________
_______________________
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