Review Request Form For Position Title, Position Change And/or Salary Upgrade Template
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1REVIEW REQUEST FORM FOR
Position Title, Position Change and/or Salary Upgrade
__________________________________________________________________________
To ensure equity and informed and timely decisions, please provide the following information to
Human Resources, along with Cabinet Member approval to initiate a review. A copy of this form should be
sent to the Budget Office.
Employee’s Name_____________ Position/Title___________Department______________________
Supervisor_________________
Request to review:
Position Title:
from ____________to _____________
Position Change:
from___________ to _____________
Salary Change:
from___________ to _To be completed by Human Resources__
FTE Change
from____________ to _____________ Funding source:___________
Effective Date of Change:_____________ _
1.
Check the primary reason(s) for this review:
____ REORGANIZATION – briefly explain:
____ SIGNIFICANT ADDITIONAL and ON-GOING RESPONSIBILITIES - briefly list
____ INTERNAL EQUITY of title ____ of salary____ (check)
To what other people &/or departments are you comparing this employee to?
Comparisons need to be similar in responsibility, skill, experience, decision making, etc.
Department(s)
Employee(s)
Positions(s)/Title(s)
Salaries (if available)
____ EXTERNAL EQUITY: title ____ salary____
What external competitive data do you have? (attach documentation if available)
University(s)/other
Positions(s)/title(s)
Salaries
_____ OTHER - Please explain:
2. Submit the following documents to Human Resources along with this completed questionnaire:
Prior year’s Performance Assessment overall rating and manager/supervisor summary.
Current job description
Revised job description (if applicable)
Other supporting documentation
3. Human Resources will also consider these factors in this review:
The employee’s position(s) and earnings history for the last 3 years
Internal data to ensure equity
External competitive College and University Personnel Association (CUPA) and other salary survey data
Other data as needed and/or available
Initiator’s signature___________Position ________ Cabinet Member signature_____________Date submitted___
Approval: Vice President for Finance and Administration______________________________Date____________
Approval: Director of Human Resources___________________________________________Date____________
Notification to Director of Financial Planning: Date: _____________________
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