Status Change Form Please enable JavaScript in your browser to complete this form. - Step 1 of 2Name *FirstLastDepartment *Date of Hire *Effective Date of Change *Today's Date *Position *Current Employment Type *Company *NextChange Employment Type From:Full TimePart TimePRNNo ChangeChange Employment Type To:Full TimePart TimePRNChange Department From:Change Department To:Change Work Comp Code From:Change Work Comp Code To:Change Rate of Pay From:Change Rate of Pay To:Reason for Rate of Pay ChangeChange FLSA Classification From:HourlySalary ExemptSalary Non ExemptNo ChangeChange FLSA Classification To:HourlySalary ExemptSalary Non ExemptCommentsNameSubmit75094 COMPANY About Us Careers NAVIGATION Services Resources Client Info Employee Info Contact Us CONTACT Office: 469-470-1077 Fax: 214-975-2331 4100 Spring Valley Road Suite 654 Dallas, TX 75035
