Request for Additional/Change of Assignment (Student Worker) – July 2015
Pasadena Area City College District
Office of Human Resources
REQUEST FOR ADDITIONAL/ CHANGE OF ASSIGNMENT (STUDENT WORKER)
IMPORTANT: This form should ONLY be used to change or add an assignment for a current Student Worker. If there is
a break in service or a classification change (example: not worked for a semester or employee is switching from College Assistant to
Student Worker),
a new Request for Employment of a Student Worker Form needs to be completed. If you are unsure, please
contact the Human Resources Office for assistance at (626) 585-7388.
_________________________________________ _________________________________________
Employee
(Last Name, First) Social Security #
_________________________________________ _________________________________________
Employee Telephone # Employee Email Address
Contact Person_____________________________Ext.___________ Department________________________________
ADDITIONAL ASSIGNMENT
Add Assignment(s)
___________ 2311 _______________ _______________ EMP#:___________________
___________ 2311 _______________ _______________ EMP#:___________________
Working Title: _______________________
Pay Rate: ___________________________
Effective Date: _______________________
CHANGE OF ASSIGNMENT
From: _________2311 __________ ___________To:__________2311 __________ __________EMP#:____________
CHANGE OF PAY RATE
Working Title: From: ________________________ To: ______________________
Pay Rate: From: ________________________ To: ______________________
Effective Date: _____________________
PLEASE NOTE: Employees cannot start employment until the Human Resources Office approves their assignment.
HR will send an email approval to the Cost Center manager indicating the effective date.
By signing this document, I certify that I have adequate funding in my budget to accommodate this expenditure
(including any employer mandated costs (FICA, paid sick leave, etc.)
Cost Center Manager’s Name __________________________ Signature _____________________ Date ______________
TO BE COMPLETED BY FISCAL SERVICES
_________________________________________________ __________________ _________________________
Position Control # Job Class # Work Location #
_________________________________________________ __________________ _________________________
Budget Approval Date Budget Reference #
TO BE COMPLETED BY HUMAN RESOURCES
_____________________________________ __________________ ________________________
Human Resources Supervisor Signature Date Authorized Start Date
