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CHANGE OF PERSONNEL STATUS

Employment Status, Location, Position, or Wage

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Your Name *

First

Last

Your Employee number *

Employee Name *

First

Last

Employee Number *

Effective Date of Change: *

Current Store/Loc. #: *

Employee Position *

_______________________________

REASON FOR CHANGE: *

Employee Request
Business Need

EMPLOYMENT STATUS: *

No Change
Part-time
Full-time
On-Call
Regular (from temporary)

WORK LOCATION: *

No Change
Change to:

Change Work Location To: *

POSITION: *

No Change
Change to:

Change Position To: *

Posted Position with Requisition Code

Posted Position with Requisition Code:

Promotion in Place

Promotion in Place (no change of duties, such as Associate MGR. to 2nd Assistant MGR.)
Distribution Center Seniority-Based Change of Assignment
Reorganization resulting in an eliminated position
Position swap (no true open position); other employee:

Promotion in Place Other

Other:

Reorder

New Manager:
New Cost Center:

New Manager:

New Cost Center:

Req Code # *

Position Swap: *

Explain Other: *

WAGE/SALARY: *

No Change
To Be Determined by HR
Change to:

New Wage *

Per:

Hour
Bi-week
Year

Manager *

First

Last

Manager's Employee # *

For a confirmation email, enter your email address here:

Your District *

District 1
District 2
District 3
District 4
District 5
Office/DC
CFO

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Drug Test Order Form Popup

Before submitting this form, please confirm that your Drug Test count in Siris is accurate. The Drug Test sku is 867811.

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