Stipend Proposed Change in Staffing
Name of person completing form *
Staff member LAST name *
Staff member FIRST name *
Type of Employment *
Type of Change *
Reason for Change/Stipend Name *
Effective Date *
1/1/2012
Replacement For (if applicable, or enter N/A) *
Building Description *
FTE *
FTE of Position
Stipend Assignment Description *
Stipend Title
If you chose 'Other' please indicate exact FTE
Ex. .671 FTE
Department *
If you chose 'Other' please indicate department
Lane (if applicable, or enter Admin Stipend, etc if not) *
Step (if applicable, or enter Admin Stipend, etc if not) *
Submit
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