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Request to Change from Limited Duration Status

This form is used by University departments to inform Human Resources of their intent to change an employee from limited duration status.

*Note: To take full advantage of this new form you will can log in using your duck id and password. Once logged in you will have a record of your previous submissions and the ability to print the PDF of the results. The log-in link is located in the bottom right-hand corner of the site.

Fill out the form and click "Submit Request," to create a printable form with signature lines.
Required items are noted with a red asterisk (*), although the more items you fill out the easier it is to facilitate your request.
If you have questions, please e-mail or contact Chris Lonigan at 6-2963.

Your Name: *

Your Phone: *

Your E-mail: *

Position to be Filled: *

The job title of the position.

Department Name: *

Classification #:

FTE:

Employee:

Effective Date:

Supervisor Name: *

Supervisor Phone: *

Supervisor E-mail: *

Position #:

Home Org #:

Funding/Index:

See policy

Statement of Justification:

Signatures

(Route through approvals required to fill positions)

Printed Name 1:

Add the name of the first required signer here.

Title 1:

Add the title of the first required signer here.

Printed Name 2:

Add the name of the second required signer here.

Title 2:

Add the title of the second required signer here.

Printed Name 3:

Add the name of the third required signer here.

Title 3:

Add the title of the third required signer here.

Header Section Links

Human Resources

Primary links

Request to Change from Limited Duration Status