Internal Job Requisition Form for Job Changes
Date of Request
Employee Name
Current Position Information
Current Job Title:
Current Department:
Please select...
Advancement
Advocacy & External Affairs
Finance
Human Resources
Learning & Evaluation
Current Manager/Supervisor:
email 1
Is Department Head:
Yes
No
Current Department Head:
email 2
Current Salary:
Current Work Location:
Current Employment Type
Full-time
Part-time
Temporary
Internship
New Position Information
New Job Title:
New Department:
Please select...
Advancement
Advocacy & External Affairs
Finance
Human Resources
Learning & Evaluation
New Manager/Supervisor:
email 3
Is Department Head:
Yes
No
New Department Head:
email 4
New Salary:
New Work Location (if applicable):
New Employment Type
Full-time
Part-time
Temporary
Internship
Additional Information
Effective Date of Change:
Reason for Change (select all that apply):
Promotion
Lateral Move
Moving Department
Department Restructuring
Temporary Assignment
Other
New Job Description:
Approval Signatures
New Manager/ Supervisor:
Signature:
Date:
Is Department Head:
Yes
No
New Department Head:
Signature:
Date:
Current Manager/ Supervisor:
Signature:
Date:
Is Department Head:
Yes
No
Current Department Head:
Signature:
Date:
HR Representative:
Signature:
Date:
For HR Use Only:
Date Processed:
Processed By:
Employee Notified Date:
Contact Information