Revised: April 2019
NORWALK-LA MIRADA UNIFIED SCHOOL DISTRICT
DIVISION OF HUMAN RESOURCES
TRANSFER REQUEST
Full Name:Emp#:
Certificated
Current Work Location:
Present Assignment/Position Title:
Classified
# of Hrs Per Day:
Email:
I hereby request a transfer from my present location. I prefer the following site(s), department(s), and grade level(s), if applicable:
Site 1:
Reason for requesting this transfer is:
Signature
EMPLOYEE INFORMATION
PRINCIPAL OR SUPERVISOR
I have had a conference concerning this above request and my comments are as follows (if applicable):
DIVISION OF HUMAN RESOURCES ONLY
Action or request:
DeniedApproved
Comments:
Non-PermanentPermanent
Employee Type:
Procedures:
1. Complete "Employee Information" section.
2. Conference with Principal or Supervisor. He/she will complete "Principal or Supervisor" section.
3. Send to Division of Human Resources after conference with Principal or Supervisor.
4. You will be contacted by the Division of Human Resources if your transfer request is granted.
Cell Phone:Home Phone:
Date
DateSignature
DateSignature
Increase of Hours Location Change
Other:
Subj./Grade(s):
Site 2: Site 3:
CERTIFICATED:
Site 1:
CLASSIFIED:
Site 3:Site 2:
Subj./Grade(s): Subj./Grade(s):
