REQUEST FOR POSITION STUDY
DEPARTMENT OF _______________________
Name: __________________________________________________________
Job Title: ________________________________________________________
Date: ___________________________________________________________
Please complete the following information and add any other pertinent information to justify the need
for a study:
1. How have the job duties changed either in scope and/or responsibility? List the critical (essential)
activities and/or functions that have been added to the position that in total require at least 25% of
the employee’s time. [A critical activity is one that takes up at least 5% of the employee’s time.]
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2. When did this change occur? _______________________________________________________
3. How long will the additional duties remain with this position?
_______________________________________________________________________________
4. Have other positions/persons received a similar change in scope or responsibility? If so, who and
when did it occur?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
5. If the level of responsibility or scope has not changed, why is a study requested?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
6. Authorization Signatures:
Do you support this request for a position study? Why or why not?
Supervisor:_________________________________________________________________________
__________________________________________________________________________________
Level 1:
__________________________________________________________________________________
__________________________________________________________________________________
Level 2:
__________________________________________________________________________________
__________________________________________________________________________________
Department Director: _____________________________________________Date: ______________
