Interested Personnel 

Instructions: This form is to be used by all Thaddeus Stevens College of Technology offices to initiate personnel actions. Prepare original and two copies; always show identifying date below (number requests sequentially, starting with No. 1 each calendar year); show type of action and complete appropriate blocks 'A' through 'M'.
Date Prepared*
Department
Request No. 16-
A. Present Class Title
B. Present BiWeekly Salary/hrly
C. Present Position Number
D. Cost Center
E. Proposed Class Title
F. Proposed BiWeekly Salary
G. Proposed Position Number
H. Cost Center
Name of Employee *
First Name
Middle
Last Name
Birth Date*
Mailing Address *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Former Name
First Name
Middle
Last Name
Municipality
Employee Number
Comments