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Full-time/Part-time Change
Email address of manager requesting change:
*
First Name
Last Name
Home location for employee:
*
Change to be made:
*
A
Change Status from Full-time to PART-TIME
B
Change Status from Part-time to FULL-TIME
* EFFECTIVE DATE MUST BE SELECTED AS EITHER THE 1ST OR 16TH OF THE MONTH.
Effective date of change:
*
* If back date is more than 30 days, please provide an explanation in the field below.
Explanation of >30 day back date
Submit