Student/Temp Status Change and Termination Authorization
Fill out form ONLY after candidate has applied for, and accepted a posted position OR employee has resigned their position.
Personnel Action *
First Name (Legal) *
Your answer
Last Name (Legal) *
Your answer
Employee Contact Information
Email address is need to send Paycor invitation to new employees
Employee Email Address
Your answer
Employee Phone Number
Your answer
Date of Hire or Rehire *
MM
/
DD
/
YYYY
End Date
Provide date when terminating students/temp employees
MM
/
DD
/
YYYY
Job Title *
Your answer
Employee Type *
Department *
Your answer
Account number *
If position is funded by department/grant use Acct Number, and if Work Study, enter '0' Financial Aid with provide the Account Number
Your answer
Pay Rate *
Your answer
Submitted By: *
Please enter supervisor name
Your answer
Special Instructions
Your answer
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