Salary Evaluation Request Form

The Salary Evaluation Request form is available free below to download, customize and print 24/7 at your convenience for your Human Resources Department, administrative office...



Does your church or organization have a request form for a salary grade evaluation on your employees?

If no, then check out the request form below for a salary evaluation. All you have to do is download, customize and print and use in your Human Resource Department or Payroll Department.



A supervisor or manager may request to have their employee's salary grade reviewed by Human Resources or the compensation department if they believe that the employee's job grade is not appropriate (too high or too low for the employee's job duties).

The supervisor is required to complete the Salary Grade Evaluation Request form below and then attach their current job description to the form. If the supervisor has any questions regarding filling out the form they can contact Human Resources or their compensation department for assistance. If the supervisor has no job description wrote up on the employee then they will need to write one specific to the employee's job. Human Resources can also help with questions on writing job descriptions. No salary evaluation can be completed without a current job description on the employee.

Once the Human Resources Department receives the request and job description, a HR representative will call the supervisor or manager to discuss the request and a reasonable time frame for the request to be reviewed.

After the request is reviewed, the HR representative will recommend one of the following actions:

  • The position should be reclassified into a higher pay range and may recommend a new higher salary for the incumbent employee;
  • The position should be reclassified into a lower pay range and may recommend a new lower salary for the incumbent employee;
  • The position does not need reclassification; however, the current incumbent employee in the position may require an in-grade salary adjustment due to the position in range. HR will recommend the new salary.
  • The position doesn't need reclassification and no salary action is required for the incumbent employee; employee pay should be dictated through the merit program.

The request form for the Salary Evaluation below includes:

  • Church or Organization's Name
  • Title of Form
  • Date - Date of the Request
  • Job Title of Position to be Evaluated
  • Current Salary
  • Name of Employee(s) in Job Classification
  • Employee(s) Current Base Pay
  • Supervisor Requesting Evaluation
  • Supervisor’s Job Title
  • Supervisor’s Contact Phone Number
  • Dept. Name
  • Reason for Evaluation Request
  • Human Resources Use Only (Below is for HR)
  • Job Description Included with Request?
  • Evaluator’s Name
  • Salary Grade Recommendation
  • Salary Surveys Utilized
  • Reasons for Salary Grade Recommendation
  • Notified Supervisor?
  • Date
  • Comments
Click on the link to download the request form for salary grade evaluation below:

Salary Evaluation Request Form


If you need to modify this form, try the site: Free PDF Services. You can convert this Adobe file into a Word document free of charge and make the necessary changes.

Note: You will need Adobe Reader (the latest version is recommended) installed on your computer in order to save or open these forms.

You can get Adobe Reader free here (a new window will open so you can download it without leaving this page).

If you want to open the file in your browser window, just click on one of the links above. However, if you want to download the file to view later, then right-click on the link and choose "Save Target As" or "Save File As". Then select where you want to save the file on your hard drive.


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Note: These sample forms are meant to serve as example forms and should not be construed as legal documents.  Please contact a legal professional for legal language for your specific organization.


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*Thank You! You're heart for giving free resources and making things so affordable is truly a blessing. My Pastor always says: "What you make happen for someone else, God will make happen for you!" May God richly bless you and your ministry to us and so many others, enlarge your territory and bring financial blessings with good measure, pressed down, shaken together and running over!!! 10,000 Blessings! Leeanna - U.S. *Disclaimer

*Thanks for making this site available. I took over as secretary of our small church a few months ago, and I am having to create a lot of forms. This site is a blessing! - Vicki - U.S. *Disclaimer

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Thank you Shepherdbase!
Brandt *Disclaimer
Anchorage, Alaska

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