Date of Request:
Requesting Manager/Department Head:
Department:
Phone Number:
Email:
Position Title:
New Position or Replacement:
New Position
Replacement
If replacement, please provide the name of the previous employee and the departure date:
Name:
Departure Date
Type of Employment: (Check all that apply)
Full-time
Part-time
Contractor
Permanent
Temporary
If temporary, please specify start and end dates
Start Date:
End Date:
Location of Position:
Is this a remote or hybrid position?
Fully Remote
Hybrid (e.g., specific days in office)
On-site only
Anticipated Start Date:
Reason for Request:
New business need
Growth
Employee promotion
Employee resignation
Briefly describe the purpose of this position within the department:
Key Responsibilities: (Please list the primary duties and responsibilities of the role. Use bullet points.)
Required Skills & Experience: (List non-negotiable skills, software proficiency, or years of experience.
Non-negotiable skill | Years of experience | Software skill | Software proficiency | Years of experience | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | ||||||
2 | ||||||
3 | ||||||
4 | ||||||
5 |
Preferred Skills & Experience: (List "nice-to-have" skills that would be beneficial but are not mandatory. Use bullet points.)
Education/Certifications: (List any required degrees, diplomas, or professional certifications.)
Direct Reports:
If yes, how many?
Reporting to (Position Title of Supervisor):
Proposed Salary Range: (e.g., $50,000 - $60,000 annually)
Is this salary aligned with the current budget?
If no, please provide a justification and indicate if a budget review is needed
Any additional benefits or bonuses to consider?
Performance bonus
Specific health benefits
Relocation package
Submitted By:
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