Request to Change the Master University Department Table (MUDT) Form
Checklist for completing the form
Checklist for a departmental reorganization
*Information requested on this form is essential and must be provided*
Questions? Contact your Budget Analyst

Check all that apply:
Add
Change
Freeze
Department
Subdepartment
Department Head
Name Change Only

Reason for the request:

Proposed New Data (see current sections below for proper coding):
Executive Level (2 digits):
Unit Level (2 digits):
Department Number (5 digits):
Department Description:
Sub-Department Code (2 digits):
Sub-Department Description:

Current Executive Level (complete if it exists, use FRS screen 2 or 6):
Athletics (5)
President (10)
Provost and Exec VP Acad Affairs(20)
Provost and Exec VP Schools & Colleges (21)
VP and CFO (11)
VP and COO (14)
VPres Admin & Operations (23) 
VPres Student Affairs (25)
VProvost Multicultural Affairs (27)
VProvost Research & Grad Educ (24)
VProvost Undergrad Educ & Admin (22)

Current Unit Level (complete if it exists, use FRS screen 2 or 6):
Admin & Operations (50)
Ag & Nat Resources (20)
Architect & Engr Srv (63)
Athletics (05)
Avery Point Reg Campus (18)
Business (23)
Ctr Continuing Studies (33)
Dining Services (74)
Education (24)
Engineering (25)
Facilities Operation (62)
Fine Arts (27)
Hartford Reg Campus (14)
Health Services (71)
HR & Payroll (56)
Law (31)
Lib Arts & Sciences (21)
Nursing (28)
Office of CFO (51)
Office of Controller (53)
Office of VP/CFO (02)
Office of VP/COO (04)
Pharmacy (29)
President (01)
Procurement & Log Serv (54)
Prov & ExVP Acad Aff (10)
Public/Enviro Safety (55)
Residential Life (72)
Social Work (32)
Stamford Reg Campus (15)
Student Activities (73)
Student Union (75)
Torrington Reg Campus (16)
Tri-Campus (19)
Undergraduate Education (13)
Univ Info Tech Svcs (39)
University Libraries (38)
University Relations (80)
Vice Provost UEA (11)
VPres Student Affairs (70)
VProv Enroll Mgt (37)
VProv Multicult Aff (12)
VProv Res & Grad Ed (34)
Waterbury Reg Campus (17)

Current Department (complete if it exists, use FRS screen 2 or 6):
Department Number (5 digits):
Department Description:
Sub-Department Code (2 digits):
Sub-Department Description:

University Department Campus:
Storrs
Avery Point
Hartford
Stamford
Torrington
Waterbury

University Department Head Information:
Name of Head
Head Employee Number (6 digits)
Unit Number
Phone Number
Is he/she the Acting Department Head? Yes No

Effective Date of Change:

Authorized by (print) (must be at least 1 level up)

Authorized by (signature) Date

If this is a change to an Academic area, has it been approved by the Board of Trustees? Yes No
Have you attached the necessary Board of Trustees minutes or other documentation (Payroll Authorization, Official Memo, etc.)? Yes No