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What change will you be making to this appointment?
Change Current Appointment Percentage
Rate Change (Hourly Employees)
End Current Appointment
Extend Current Appointment
Termination of Employee
New Hourly Rate:
New End Date:
Current Type of Appointment (i.e. Lab Manager or Student Hourly)
Is this individual starting a new appointment or no? If they are starting a new appointment, please use
Starting new appointment (form submitted)
No other appointment
Please upload a completed employee separation form or resignation letter here, or email one to email@example.com
Name of the person submitting this form:
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