Work Schedule Change – Request Form Work Schedule Change Step 1 of 3 33% Preparer Information Preparer Name(Required) Your name First Last Preparer UW Email(Required) Your UW email address Alternate Contact In the event of your absence, who should be contacted? First Last Alternate Contact UW Email Alternate contact's UW email address EO Assistance(Required) Did you consult with or receive assistance from an Executive Office Shared Environment team member prior to filling out this form? No Yes Team Member Name First Last Employee Information Employee Name(Required) First Last Employee UW Email(Required) Employee Unit(Required) -CHOOSE ONE-Academic Personnel & Faculty (APF)Academic Strategy & Affairs (ASA)Division of Campus Community Safety (DCCS)Faculty SenatePresident (PRES)Provost (PROV)Attorney General's Office (AGO) APF Sub-Units(Required) -CHOOSE ONE-APF: Faculty AffairsAPF: Faculty DevelopmentAP: Faculty Inclusive Excellence ASA Sub-Units(Required) -CHOOSE ONE-ASA: Academic Technologies (AT)ASA: EM: AdmissionsASA: AdvancementASA: Center for Teaching & Learning (CTL)ASA: CoreASA: Enrollment Management (EM)ASA: EM: Financial AidASA: Information Services (ASA-IS)ASA: EM: International Student Services (ISS)ASA: EM: Registrar (OUR)ASA: Strategic Initiatives DCCS Sub-Units(Required) -CHOOSE ONE-DCCS: CoreDCCS: SafeCampusDCCS: Emergency ManagementDCCS: UWPD This field is hidden when viewing the form HSS Sub-Units -CHOOSE ONE-HSS: Academic Services & Facilities (AS&F)HSS: CoreHSS: Interprofessional Education (IPE) PRES Sub-Units(Required) -CHOOSE ONE-PRES: Board of Regents (BOR)PRES: CorePRES: Environmental Health & Safety (EH&S)PRES: Internal Audit (IA)PRES: OmbudPRES: Population HealthPRES: University Rules & PolicyPRES: UWINCO PROV Sub-Units(Required) -CHOOSE ONE-PROV: CorePROV: Health Sciences ServicesPROV: Scientific Instruments Work Schedule Changes Effective Date(Required) New work schedule effective date MM slash DD slash YYYY Employee Change Request(Required) Who is initiating this request? Employee Management FTE Change(Required) Does this work schedule change include an FTE change? Yes No New FTE Percentage New Work Schedule(Required) Ex: M-F 8-2 PST Correspondence Documentation Upload(Required) Upload correspondence of schedule change request (employee initiated and manager approval). Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 15 MB. Notification Documentation Upload(Required) Upload formal notification of schedule change. Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 15 MB. Additional Information Provide any additional, relevant information on needed action.