IT Employee Update Form
Move/Add/Change Form
Section A: Request Type (REQUIRED)
Staff Move (Req: B/C/E)
Staff Add (Req: B/D)
Staff Change/Terminate (Req: B/E)
Student Add (Req: F)
Section B: Personnel Information
1.
Employee Name: (First, Last)
2.
Department/School:
3.
Phone Ext. (If Available)
Alternative School
Animal Control
Central Office
Chalk Hill
Edith Wheeler Memorial Library
EMS
Fawn Hollow
Fire Marshal
Firestation 1
Firestation 2
Food Pantry
Great Hollow Lake
Highway Dept.
Jockey Hollow
Masuk
Monroe
Police Dept.
Remote Support
Senior Center
St. Judes
Stepney
Tech Center
Town Hall
WebSite BOE
WebSite PD
WebSite TeacherWeb
WebSite TH
Wolf Park
4.
Title/Position (Indicate current and/or new)
5.
Type (Select One)
F/T
P/T
Temp
Section C: Move Request
1.
Reason for Move:
Employee Transfer
Reorganization
Other (Details Required)
2.
Move Details: (Provide details regarding this move request)
3.
Special Requirements:
Section D: Add Request
1.
Hire Date
2.
Hiring Supervisor/Email Address:
3.
Seating Location/Notes:
4.
Requires (Check all that apply)
E-mail
PowerSchool
Internet
Phoenix HR
Telephone
Phoenix FS
VPN
Access to Share
Other
Section E: Change/Termination Request
1.
Effective Date of Change/Termination:
2.
Supervisor/Email Address:
3.
Seating Location/Notes: (Optional)
4.
Change Type (Check all that apply)
Transfer/Promotion
Separation
Archival Required?
Other
5.
Change Last Name:
Section F: Student Information
1.
Student Name: (First, Last)
2.
Student School:
3.
Graduation Year:
4.
Student Number
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
5.
Person Submitting Form/Email Address
Additional Information