Extra Help Requisition
 
Employee Information:

* Last Name:

* First Name:

* UIN :

* Address:

* Position:

* Administrative unit:

* College Department Code:

* Duties:
* Work Schedule: Full Time
Part Time

* Hours per week:

* Work Days:

* Does this position require a physical? Yes No

* Does this position require a Drug Screen? Yes No

* Does this position have direct patient contact? Yes No

* Is this position security sensitive? Yes No

* Does this request replace a civil service position? Yes No

If yes, please indicate the reason for this request:
Vacation Sick Leave Leave of Absence Other

Contact Information:

* Department Contact:

* Department Contact Email:

*FOAPAL Account Number:

* Requested Salary:

* Room Number:
* Building Name:
* Street Address:
* Phone Number:
* Mail Code:
* Department Head:

HR Office use only:
PITR
Paperwork
Ethics Training
Completed

 

Produced by:
Department of Human Resources - UIC
Last Update: 15-Jun-2006