HR Job Evaluation Change Request
Employee & Position Details
Employee Name
Current Job Title
Department
Immediate Supervisor/Manager
Date of Request
Requested Change
Type of Change
Job Title Change
Job Description Update
Job Grade/Band Change
Change of Role/Scope
Other
Proposed Effective Date
Proposed New Job Title (if applicable)
Proposed Job Grade/Band (if applicable)
Justification for Change
Please provide a detailed justification for the requested change
Summary of Role & Responsibilities
Current Duties & Responsibilities
Proposed/Updated Duties & Responsibilities
Additional Information
Other relevant information
Request Submitted By
Submission Date