Organizational Change Form

This form should be completed by the supervisor of the employee(s) affected by an organizational change at least two weeks prior to the effective date of change; if you need assistance completing this form, please contact the Office of Human Resources (ext. 2285).  When you submit this form and any appropriate documents, it will be sent to your Cabinet Vice President; after his / her approval, it will be routed to the Office of Human Resources.

  • Employee / Department Information

  • Nature of the Change

  • Where a department or individual moves to (location / building & room #)
  • MM slash DD slash YYYY
  • Supporting Documentation

  • Max. file size: 5 MB.
  • Comments

  • Requester