APPLICATION FOR TRANSFER
Name: ID#
Current Job Title Current Campus/Center Location
I hereby apply for a transfer of assignment from that listed above to:
New Job Title New Campus/Center Location
Replacing:
Reason:
I certify that I am eligible for transfer regarding this subject.
Employee Signature
Date
Current Supervisor Signature Date
Current Vice President Signature
Date
New Supervisor Signature Date
Approved New Vice President
Date
Approved President
New Salary: Start Date:
Mississippi Delta Community College does not discriminate on the basis of age, race, color, national origin, religion, sex, sexual
orientation, gender identity or expression, physical or mental disability, pregnancy, or veteran status in its educational programs
and activities or in its employment practices. The following person has been designated to handle inquiries regarding the non-
discrimination policies: Steven J. Jones, Vice President of Administrative Services, Tanner Hall, Suite 202, P. O. Box 668,
Moorhead, MS 38761, 662-246-6304; EEOC@msdelta.edu.
Revised 01-27-2021
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