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

Full-TimePart-Time

Proposed Effective Date:

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

YesNo

Is this a Grant Funded Position?

YesNo

Is there a NTE Date? If so, please provide

Is this a Supervisory position?

YesNo

Will this request require budget reprogramming?

YesNo

Will this position receive full benefits?

YesNo





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

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

YesNo



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