<p> Temporary Worker Requisition Form Completed by Hiring Manager *Any forms submitted incomplete will not be reviewed; the form will be returned for your completion which could result in delayed recruiting.</p><p>Job Title: </p><p>Direct Reports to Name: Dept #: Physical Office Location: Budgeted: Yes No Today’s Date: Target Start Date: Scheduled Weekly 37.5 hours Hours 40 hours Duration: Select One*</p><p>Reason for Position: Select One If replacement, Previous Incumbent: Previous Incumbent Salary: </p><p>Budgeted Salary: </p><p>Further Justification: </p><p>*Please include (where applicable) MOS Dashboard Data, claim count totals, floater availability, etc</p><p>Please provide specific details or nuances that should be included in the advertising of this position. (Ex: bilingual, specific license or certifications, if candidate already in mind)</p><p>Recruiting Team: Designated contact person and/or group of contacts who will receive and review resumes. (Ex: This individual/individuals will be forwarded possible candidates and provide feedback to HR. They will also have access to the open position in OpenHire)</p><p>Form Submitted By: Title </p><p>Please Email the completed form to [email protected] This requisition form will be submitted for approval and a recruiter will contact you to discuss recruitment strategy. </p><p>Position Requisition Form Revised: 12/2013</p>