Job Requisition Form

Date __________

Position title ________________________________________________
Department _________________________________________________
Hiring manager ______________________________________________

___ Full-time   ___ Part-time   

___Exempt     ___ Nonexempt

___Salaried     ___ Hourly             

Recommended Salary Range: __________________________________

[ ] Weekly                    [ ] Hourly
[ ] Regular                   [ ] Temporary
[ ] Full time                  [ ] Part time

[ ] Day   [ ]Swing     [ ] Grave     [ ] Differential

Preferred Start Date: _______________________

Reason for Recruitment

(New or updated job descriptions must be attached for all positions.)

___ Replacement position

            Name of person being replaced_____________________________

            Have the duties of this position changed? ___ Yes ___ No
            (If yes, provide details in position information section.)

            Pay grade/range _________________________________________

___ Reallocated position (reallocation of vacant, budgeted position within department)

            Name of current vacant position_____________________________

            Current pay grade/range                                                                           

            Recommended pay grade/range_____________________________

___ Budgeted new position (job description attached)      

           Budgeted pay grade/range________________________________

___ Nonbudgeted new position (job description attached)
           Recommended pay grade/range____________________________

Position information/justification
(Indicate what changes were made to the job description or provide justification for new position.)

____________________________________________________________
____________________________________________________________
____________________________________________________________

Special advertising/recruitment request:____________________________
____________________________________________________________

Hiring Manager Approval _______________________     Date  _________

Department Head Approval _____________________     Date  _________

VP Approval _________________________________     Date  _________

HR Approval _________________________________     Date  _________

Please return to Human Resources once completed

 ________________________________________________________________________

Approval to Job Offer
This section to be completed by HR only

Name of Candidate ______________________

Proposed Wage __________ Proposed Start Date __________

Reason for Hire _____________________________________________
___________________________________________________________

Approved      _______________________________________________
                           HR Director                     Date