Position:
Department:
No. of Person(s)
Date Needed By:
If position is temporary, how long will person(s) be needed?
Hours Available: (Part-time - scheduled 30 hrs. or less weekly or Full-time - scheduled 30-40 hrs. weekly) 10-20 Hours
20-30 Hours
30-40 Hours
Indicate all shift times needed: (Note whether shift is a.m. or p.m.) 1.
2.
3.
4.
Days of the Week Needed: (Check all that apply) Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Special Requests/Requirements
Requested By: (Supervisor)
Date Requested:
Approved By: (Department Manager)
Date Approved:
