Employee Status Change Request Form

Employee Status Change Request Form

Employee Status Change Request Form
Effective date*

MonthDayYear
Date
Team Member Name:*

First NameLast Name
Store Location:*
Position Change
From:*
To:*
If TERMINATION/QUIT, please fill out paper form and scan to us.
Pay Rate Change
From Pay Rate $
To Pay Rate $
Authorized by:*

First NameLast Name
Comments:*
Should be Empty: