Employee Job Title Change

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					                                    LYNWOOD UNIFIED SCHOOL DISTRICT
                                                       Classified Personnel
                                        11321 Bullis Road ◦ Lynwood, CA 90262-3600
                                               (310) 886-1490 Fax (310) 635-5143

                                       JOB TITLE/DUTY CHANGE REQUEST FORM

THE JOB TITLE/DUTY CHANGE REQUEST FORM MUST BE COMPLETED BY THE INDIVIDUAL AND/OR SUPERVISOR INITIATING
THE REQUEST. PLEASE COMPLETE THE INFORMATION BELOW , AND RETURN TO THE CLASSIFIED PERSONNEL OFFICE
WITHIN TEN (10) WORKING DAYS.

INDICATE DESIRE ACTION TO BE TAKEN BY CHECKING ONE OF THE FOLLOWING:
                  JOB TITLE CHANGE ONLY         DUTIES CHANGE ONLY                             JOB TITLE & DUTIES CHANGE

IS THIS REQUEST FOR A CURRENT EMPLOYEE?       YES          NO                EMPLOYEE NAME:

IS THIS REQUEST FOR A CURRENT VACANT POSITION?       YES          NO         POSITION TITLE:

IS THIS REQUEST TO CHANGE THE JOB TITLE FOR ALL EMPLOYEES DESIGNATED IN THE POSITION?          YES           NO

INDICATE JOB TITLE THAT ACCURATELY DESCRIBES THIS POSITION:


INDICATE THE APPROXIMATE NUMBER OF EMPLOYEES THAT MAY BE AFFECTED BY THIS REQUEST:

FOR CHANGE IN DUTIES, PLEASE LIST THE REVISED DUTIES HERE:




                               (YOU MAY ATTACH AN ADDITIONAL SHEET OF PAPER IF SPACE IS NOT SUFFICIENT)
EXPLAIN THE REASON(S) FOR THE REQUEST TO CHANGE THE JOB TITLE:




                                 (YOU MAY ATTACH AN ADDITIONAL SHEET OF PAPER IF SPACE IS NOT SUFFICIENT)


                ALL CLASS SPECIFICATION(S) REVISED ARE SUBJECT TO APPROVAL BY THE PERSONNEL COMMISSION.


EMPLOYEE’S SIGNATURE:                                                                                DATE:

ADMINISTRATOR/SUPERVISOR SIGNATURE:                                                                  DATE:




                                                                                                                   REVISED 3/31/2010

				
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