ࡱ>  bjbj΀ **mmmmm4%df nl6888888Y "Z8umTnnTT8mmT mm6T6@qZ%^ "0U#hfU#U#mTTTTTTTT88TTTTTTTU#TTTTTTTTT* 3: JOB CHANGE REQUEST FORM Administrative & Professional Staff, Faculty, & Graduate Assistants (For changes other than extensions of appointment periods) Acting positions may not be given an appointment period which exceeds one year.Legal Name: FORMTEXT      Soc Sec No: FORMTEXT      Banner ID: FORMTEXT      Campus:  FORMCHECKBOX  Alton  FORMCHECKBOX  ESL  FORMCHECKBOX  Edw  FORMCHECKBOX  SpfldBox: FORMTEXT      Bldg & Rm No.: FORMTEXT      Phn w/Prefix: FORMTEXT      POSITION/JOB INFORMATIONCURRENT STATUS:**Please do not use the delete key or backspace key in the Hrs. Per Pay column or the Actual Assign Salary column.**POSN TITLE/RANKPOSN No.Full-Time Semi-Mo Salary Base Appt. Percent (4 decimal places max, e.g., 33.33)**Hrs. Per Pay (F9 to calc)**Actual Assign Salary (F9 to calc)Account TitleOrg/ DDU AIS Budget Purpose  =.8156*D1 \# "0.00" 0.00 =PRODUCT(C1,D1)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D2 \# "0.00" 0.00 =PRODUCT(C2,D2)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D3 \# "0.00" 0.00 =PRODUCT(C3,D3)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D4 \# "0.00" 0.00 =PRODUCT(C4,D4)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00CHANGE STATUS TO: =.8156*D6 \# "0.00" 0.00 =PRODUCT(C6,D6)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D7 \# "0.00" 0.00 =PRODUCT(C7,D7)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D8 \# "0.00" 0.00 =PRODUCT(C8,D8)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D9 \# "0.00" 0.00 =PRODUCT(C9,D9)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00 =.8156*D10 \# "0.00" 0.00 =PRODUCT(C10,D10)*.01 \# "$#,##0.00;($#,##0.00)" $ 0.00GRANTS OFFICE APPROVAL (Grant Accounts Only):Approved by:Date: EFFECTIVE DATE(S) FOR CHANGE: Beginning  FORMTEXT      Ending FORMTEXT       or  FORMCHECKBOX  ContinuingTYPE OF APPOINTMENT: Academic:  FORMCHECKBOX Faculty Continuing  FORMCHECKBOX Faculty Term  FORMCHECKBOX Grad Asst (term only) Fiscal: FORMCHECKBOX Faculty Continuing  FORMCHECKBOX Faculty Term FORMCHECKBOX Grad Asst (term only)Admin/Professional Staff:  FORMCHECKBOX Administrative Staff Continuing  FORMCHECKBOX Administrative Staff Term FORMCHECKBOX Professional Staff Regular (IEA/NEA) FORMCHECKBOX Professional Staff Durational (IEA/NEA)COMMENTS & JUSTIFICATION:  FORMTEXT       FORMCHECKBOX  This extra service is over and above services required by the current budgeted contract. It will not affect performance under such contract.READ BEFORE SIGNING: The applicant agrees that if appointed, his or her conditions of employment will include the laws of Illinois, including Board of Trustees legislation, and all policies and regulations, including those of SIUE, from time to time issued pursuant thereto, and any applicable collective bargaining agreement, all of which will be as much a part of the applicant's employment contract as if set out in full therein, and that such terms and conditions as from time to time amended will continue to govern in any change of assignment or renewal of the appointment.Signature of Staff MemberDatePlease sign and make a file copy before forwarding. FORMCHECKBOX  As defined by the Office of the Secretary of State and based on the responsibilities assigned to this position, the employee will be required to complete a Statement of Economic Interest. 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