Extension Request Form

Extension Request Form

Current position*

Please enter job title if known, otherwise enter "staff" or "temp."

Supervisor name*

Insert name of current supervisor

Supervisor email*

Email of current supervisor

Extend appointment?*

Yes

Not sure at this time

Is this position related to the care of plants or animals?*

Yes

Is this position (or change) critical for your section/department?*

Yes

Critical position justification*

Reason for NOT extending the appointment?*

Term date*

Enter current appointment term date.

New proposed term date*

In addition to extending this appointment, would you like to request any of the appointment updates listed below? If not, please choose "No update requested."*

Start date*

Enter start date for change in appointment requested.

New hourly pay requested*

Current number of maximum hours authorized to work per week*

Proposed number of hours per week*

New annual pay requested*

New proposed job title *

Justification for change *

Timeline for ending appointment*

Allow appointment to end on term date.

Employee is leaving position before term date.

Enter employee's last day of work.*

Explanation of uncertainty*

(e.g., funding is not finalized, project end date uncertain, etc.)

New supervisor name*

Enter name of new supervisor requested.

New supervisor email*

Pay*

Hourly or Annual Rate

Choose "Hourly" for all temp positions.

Choose "Annual" for all Postdoctoral Associates/Fellows.

Hourly

Annual

Pay/hour*

The minimum hourly rate for a temporary employee is $20.

Pay/Annual*

For Postdoctoral Associates only: The current minimum salary is $61,000.00.

Hours per week*

For Postdoctoral Associates/Fellows positions, enter 40 hours.

% FTE*

If this a Postdoctoral Associate/Fellow hire request, enter "100" for %FTE.

Is there more than one funding source?*

Yes

Account to Charge (7-digits)*

Funding Percentage*

Account to Charge (7-digits) (2)*

Funding Percentage (2)*

Additional Funding Source?*

Yes

Account to Charge (7-digits) (3)*

Funding Percentage (3)*

Financial approver*

(Please do NOT choose Cindy or Roxana. They are listed here for testing purposes only. Thanks!)

Cindy Twardokus (ct259@cornell.edu)

Linda Cox (ljs42@cornell.edu)

Roxana Usturoi (ru32@cornell.edu)

Tracy Chapman (tlk2@cornell.edu)

Does the employee currently have an assigned office?*

Yes

Request office space?*

Yes

Retain office space?*

Yes

Request a different office

Does {{Employee name}} need visa sponsorship?*

Yes

Remote work*

Fully remote

Remote and in-person

Fully in-person

In which state will the work be performed?*

Brief job description*

File Upload

If requesting a reclassification or promotion, please upload a completed Staff Position Description (SPD) and Position Evaluation and Analysis form.

Drag and drop files here or

Send me a copy of my responses