HomeMy WebLinkAboutPersonnel Action Request - New Hope DV/SAPERSONNEL ACTION REQUEST (PAR)
Sectiont — Core Employee Data (Current Data Required)
-Empl#: 4784
Legal Name. Adolphsen, Elisa
Effective Date,: og/1 ol/21
Section. 2— Employee Data (Required for New Hires Separat*
ions, or if Chanping)
Item
CurrentData
New Data
Name 0 Legal
0 Preferred
<Enter>
Address
<Enter>
Telephone
_(000) 000-0000 ext.
- ext,
SIS# - Birthdate
of o- – oo/oo/oo
000-00-0000 – 00/00/00
Sect iOn'3 Requested Action
Action(s)
Leave Data
Separation Data
Wage Change - Adjustment
A
Start Date oo/oo/oo
Stop Date oo/oo/oo
Type
A
Reason
A
Eligiblefor Rehire A
Provide`: etails of Separation Below
'Section 4-, Comments
Reclassification: Creation, of Children's Advocacy Center Coordinator 1 and Children's Advocacy
Center Coordinator 2. Employee will be r- eclassifed to the 2 level in recognit lb n- of her therapy
training. The employees is receiving a 2,79% 'Increase as the -step increase due and then a 14.64%
reclassification increase. (17.8% total increasei
sectlOfi 5 — COre Items (Current Data Required)
Jte771
Current Data
New Data
Dept# -Dept
New Hope—»28000 A
A A
Job# -job, Title
170 -22 -Children's Advocaty Ctr Coord
----------
-Children's Advocaty Ctr Crd
Hire – Positi on
04/22/19 - 09/01/1-9
04/22/.1 - 09/01/21
Grp -Nam
Employee, T
NO3-Maeager- Supemsor
I` ll Time Regular
A
A
..... . ------ -------- Section 6 — Secondary Items s (Required only if Ch.anging)
Item
Current Data
New Data
Base Wage.,-
$5,279.73 Monthly
$6,220,93 Monthly
Band/ Step
13/03,
14/04
Stipend
$00.0000 <Select Type>
$00-0000 <Select Type>
Pay Type/FLSA
Exempt (SALR E)
A
FTE
Lo (4o hrs/wlr,)
A
FTE–GrIS Only
<Enter>
<Enter>
Workweek
Standard Sun -Sat
A
Q
Section 7 Authorizing SIgn atures
Department, Date.*
Human Resources: Date,
Board Approval -Je� d, o gy re
Chair:
Vice -Chair, Date, 12
Member,
Revised 05/25/2021