REQUEST FOR SENIORITY ROSTER CORRECTION
(May be filled out electronically and forwarded to Terri Davis at tdavis@bemidjistate.edu)
In accordance with Article 29 of the 2009-2011 Master Agreement, I hereby request the following
correction(s) to the 2012 Seniority Roster. [Check all applicable.]
_____ My name is listed incorrectly. I should be listed as:
________________________________________________________________________
_____ My type of appointment is listed incorrectly. I should be listed as:
________________________________________________________________________
_____ My full-time/part time status (or percentage if part-time) is listed incorrectly. My status/percentage
should be listed as:_________________________________________________________
_____ My date of initial employment is listed incorrectly. The date should be listed as:
________________________________________________________________________
_____ My date of tenure is listed incorrectly. The date should be listed as:
________________________________________________________________________
_____ My years of seniority are listed incorrectly. My years of service should be listed as:
________________________________________________________________________
_____ I am not listed on all of the department/program rosters in which I have seniority rights. In
addition to my current listing(s), I should also be listed on the following roster(s):
________________________________________________________________________
_____ Instead of my current listing(s), I should be listed on the following roster(s):
________________________________________________________________________
_____ Other [Explain] ___________________________________________________________
________________________________________________________________________
Please let me know if you need any information from me to evaluate my request for correction(s). In the
event that my request for correction is denied, I request that an explanation for the basis of denial be
provided to me and the Faculty Association. I look forward to hearing from you soon.
_____________________________________________
Faculty Name (Print)
_____________________________________________
Faculty Signature
C: Faculty Association
Date____________________________