This form was created and is being used internally by the Department of Medicine, Office of Human Resources. This form is intended to be submitted by Department of Medicine, Section Business Managers. All fields must be completed.
Position Type: New Position
Replacement
If this is a replacement indicate former employees name/title:

 

Proposed Title:

 

 

click here for
a list of titles
Work Schedule:

FTE: %       

Hours per week:
hrs.   

Days:
Monday - Friday      
Other (specify)

Is this position: Security Sensitive? Yes   No
  Direct Patient Care? Yes   No
  Drug Screening? Yes   No

 

 

   
  
Special Qualifications: (including desirable characteristics/special qualifications):
Employee will report to: Name:   Section Business Manager: Name:
Section:   Section:
Office Phone:   Office Phone:
E-mail:   E-mail:

 


 

 
Last Update: Thursday, September 29, 2011