This form must be completed and submitted for review by CMCI HR before any staff personnel action can be initiated.

Staff personnel actions include but are not limited to creating a new position; hiring to fill a vacant position; revising and/or reclassifying a position; changing a position title or job code; requesting temporary additional pay or a change in salary; changing the percent time of a position.

If you’d like a consultation about the action you’re requesting before submitting the form, please email CMCI Faculty Affairs & HR at

Please complete the following:

Requester Information