Online supervisory reporting structure change form

Please provide the following information exactly as your would like to have it appear on Division supervisory reporting structure report. If you do not want an item included (for example, your email address) simply leave the field blank.

Division	Department

If Other Division, specify below:	If Other Department, specify below:

Employee Information

Name:	(*)
Position#:	(*)
Position Title:	(*)
DU ID#:	(*)

OLD Supervisor Information (leave blank if new hire or no previous supervisor)

OLD Supervisor's Position#:
OLD Supervisor's Name:
OLD Supervisor's Title
OLD Supervisor's DU ID#:

CURRENT / NEW Supervisor Information

(leave blank if employee is separating from an appointed position at the University)

Supervisor's Position#:
Supervisor's Name:
Supervisor's Title
Supervisor's DU ID#:

Effective Date of Reporting Structure Change

Date of Change:	(*)
Reason for Change:

Comments

Reported by

Your Name:	(*)
Your Email:	(*)
Your Phone #	(*)
Your Position Title	(*)
Your Division Title	(*)

Required items are noted with an (*).

You will receive an email confirming the changes you submit. Changes will show in the next Division supervisory reporting structure report (provided by Human Resources, or upon your request).