Labor Release - Adjustment Form
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Labor Release / Position Adjustment Form
GENERAL GUIDLINES
When making adjustments to a position -- Complete Sections A, B, D
When releasing from a position -- Complete Sections A, C, D
NAME __________________________________________________________
CPO _____________________
A
STUDENT ID NUMBER __________________________
EFFECTIVE DATE (MDY) _____ / _____ / _____
DEPARTMENT _________________________________________ POSITION _____________________________
The action being taken on this page is for a student labor position for the following period:
Spring;
Fall;
Summer;
Spring Break;
Christmas Break;
Yearlong
DEPARTMENTAL ADJUSTMENTS TO STATUS FORMS
Please check appropriate action(s). Skip section C and go to section D.
Decreasing Hours from _____to _____
Increasing Hours from _____ to _____
B
Change WLS Level from _____ to _____ Change position codes from _______________to_______________
*All departmental adjustments become effective at the beginning of the next payroll period.
Please Print The Supervisor Name For This Position:
LABOR RELEASE / CHANGE OF POSITION
Complete this section when releasing a student from a position or changing a student’s position within a department.
Released From Department:
Primary ( ) Secondary ( )
CONDITION AT RELEASE:
Satisfactory Performance
Unsatisfactory Performance
Release / Change Position Code from _____________ to _____________
CONDITION AT CHANGE:
Satisfactory Performance
Unsatisfactory Performance
Please rate this student on the following performance expectations
Performance Expectation
Evaluation Scale
Score
For performance descriptors and evaluation
C
scoring information, please refer to the
Attendance
0 – 20
Student Labor Evaluation Form located at:
Accountability
0 - 10
Teamwork
0 - 10
dentlaboreval/default.asp
Initiative
0 - 10
TOTAL SCORING KEY
Respect
0 - 10
Learning
0 – 20
60-100
Satisfactory
59-below
Unsatisfactory
Job Specific
0 – 20
TOTAL
SUPERVISOR COMMENTS:
D
Student’s Signature
Date
Staff/Supervisor’s Signature
Date
NOTE: Student signature is recommended but not required when releasing from a position
Student Payroll • Fairchild Hall 100 • CPO 2176 • Phone: 3317
Date entered ________ By________
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Parent category: Legal