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Request to Hire Employee

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					                                   TEMPORARY/NON-BENEFITED STAFF
                                       REQUEST FOR HIRE FORM
                                   This form is to be completed by the supervisor and submitted to the
                           Human Resources Office for approval before hiring a temporary/non-benefited employee.
TEMPORARY/NON-BENEFITED NEW HIRE INFORMATION
                                                                                                MIDDLE
LAST NAME:                                      FIRST NAME:
                                                                                                INITIAL:

SOCIAL SECURITY NUMBER:                                       HOME PHONE:

STREET ADDRESS:

CITY:                                             STATE:                          ZIP:

HAS THIS PERSON COMPLETED A STAFF APPLICATION AND STATEMENT OF FAITH?
                                                                                               Yes         No
*INCLUDE THESE APPLICATION MATERIALS WITH THIS FORM*

HAVE REFERENCES BEEN CONTACTED?               Yes       No



TEMPORARY/NON-BENEFITED POSITION AND SALARY INFORMATION
POSITION TITLE:

DEPARTMENT NAME:

SUPERVISOR OF POSITION:

WAS A POSITION DESCRIPTION SUBMITTED TO HUMAN RESOURCES?
                                                                                               Yes         No
*IF NOT, INCLUDE WITH FORM*

EMPLOYMENT STATUS (CHECK ONE OF THE FOLLOWING):

   Staff Employee without Benefits (Must Be Less Than 20 Hours Per Week)

   Temporary Employee (All Temporary Positions are Without Benefits and are for a Limited Duration of Time)

REASON FOR TEMPORARY/NON-BENEFITED EMPLOYEE HIRE:




HOURS PER WEEK (All Temporary Employees Must use Timecards)


Non-Benefited Employee–Hours Per Week:              Beginning Date:

Temporary Employee–Hours Per Week:                  Beginning Date:                   Ending Date:


PROPOSED HOURLY SALARY:                             PAY RANGE:                     PAY STEP:

                                                    OBJECT              IS THE SALARY
ACCOUNT NUMBER TO BE CHARGED:                                                                        Yes        No
                                                    CODE:               WITHIN BUDGET?

TEMPORARY/NON-BENEFITED STAFF REQUEST FOR HIRE APPROVED

HIRING MANAGEMENT:                                                                 DATE:

HUMAN RESOURCES:                                                                   DATE:

BUDGET APPROVAL:                                                                   DATE:

PAYROLL SPECIALIST (INPUT ONLY):




                                                                                                  HR Revised 12/19/06

				
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