SALISBURY UNIVERSITY

							            NOTIFICATION OF PERMANENT WORK SCHEDULE CHANGE


Employee: __________________________________     Empl ID: ________________________________

Department: ________________________________     Position: ________________________________

Effective Date: ______________________________   Work Location or Unit: ____________________



Current and changed schedule:

Schedule/Shift Wednesday Thursday       Friday    Saturday    Sunday     Monday     Tuesday

   Current

    Change



Supervisor Comments: __________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

______________________________________________      _____________________________________
Supervisor’s Signature                               Date



Employee Comments: ___________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_____________________________________________      ______________________________________
Employee’s Signature                                Date




02/2006