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REQUISITION FORM

For Staff Positions


_________________________________
President Approval/Signature
Title:___________________________________

JobCode:___________

Department:____________________________________

Full-Time

Working Hours:_________________

Position Available :__________________________________

Part-Time

Hours per Week:_________________

Closing Date:

Temporary

Ending Date of Employment (if temporary) :_________________________

Education Required:____________________________________________________

___________________________________

Minimum Rate (Pay Plan): ___________________________________


Preferred:__________________________________________

Other skills ( not included in job description)


________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
(i.e., Read/Write, Typing, CRT, Shorthand, Calculator, Copier, Computer,Specific software, etc.)
Experience Required:________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Preferred:_________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Supervisory Responsibility? ______ Yes______ No Special Physical Requirements: ___________________________________________________________
Description of Job Duties (not included in job description):
____________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Will incumbent be driving a University vehicle__________;
New position: (yes____ no____)

and/or personal vehicle for University business___________.

Replacement: (yes____ no____)

Replacement for:______________________________________________ who is ________________________________________________


Source of Funds
Account number:____________________________________________________________________________________________________

_________________________________________________
Signature: Department/Budget Head/Supervisor

___________________________________
Date

_________________________________________________
Signature: Vice President

___________________________________
Date

HR Use Only
Total Number of Applicants: ____________
Applicant Hired:

Number of Applicants Interviewed: ___________

Date Job Filled: ____________


Letters Sent: ___Y ___N

Rev09.03

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