HR Intake Form

Date of Request

Request Type

Do you have an existing position number for this request?

YesNo: New Position

Area of Consideration (for recruits only)

Agency OnlyOpen to the Public

Full time/Part Time


Proposed Effective Date:

Will this request impact the current fiscal year's budget?


Is this a Grant Funded Position?


Is there a NTE Date? If so, please provide

Is this a Supervisory position?


Will this request require budget reprogramming?


Will this position receive full benefits?


Please provide information for the person that will be managing this request.

Has this request been approved by your Dean and/or Vice President?


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