Status Change Report Form - New Westminster Schools
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1School District No. 40
STATUS CHANGE REPORT FORM
Name of Employee:
Location:
CHANGE OF FTE/HOURS WORKED
Increase in FTE*
From
to
From:
To:
Increase in hours/week
From
to
From:
To:
Decrease in FTE*
From
to
From:
To:
Decrease in hours/week
From
to
From:
To:
Schedule of days/hours (indicate start/end time) for Support Staff:
Schedule of days (if ½ day indicate a.m. or p.m.) for Teaching Staff:
Employee Signature:
Date:
CHANGE IN ALLOCATION
Current Allocation
FTE or HRS Budget Code
Location
New Allocation
FTE or HRS Budget Code
Location
POSITION OF SPECIAL RESPONSIBILITY ALLOWANCE
Add POSR allowance
Title:
Allowance amount $
Effective:
to
Allowance %
date
Remove POSR allowance
Title:
Allowance amount $
Effective:
to
Class Size & Composition
Compensation:
Number of students over 30:
Effective:
to
date
SALARY CHANGE
Salary/Wage Increase
Title:
Increase amount $
Effective:
to
Allowance %
date
Supervisor Approval:
Date:
Board Approval:
Date:
Posted by HR:
Date:
PLEASE FORWARD THIS ORIGINAL FORM TO HUMAN RESOURCES ASAP
Copies to: Payroll, Principal/Supervisor, Employee, NWTU/CUPE, Dispatch Office, Personnel File
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Parent category: Business