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Agency It Temp Request - Agency_it_temp_request

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05/16/06
Information Technology (IT) Temporary Request Form – Contract Labor
Individuals who are hired through the temporary agency as per contract with the State of Kansas are
employees of the agency.
Date:
Classification Desired:
Supervisor:
Department:
Dept. Location:
Ext.
Box:
Work Hours
Date Needed:
Length of Assignment:
Hrs per week:
SKILLS REQUESTED
(Note: Level of skills requested will determine classification and salary of position)
Skills Required (indicate if preferred and not required)
Duties/project for assignment:
OHR AUTHORIZATION
OHR Signature
Date
Temp Agency
Contact person
Phone
Temp Employee's Name
Start Date:
Screening: DMV SOF
Original: OHR Copy: Hiring Department
Special Requirements:
Dress Code:
Authorization:
Date:
Supervisor Signature
Authorization:
Date:
Budget Officer Signature
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Agency It Temp Request - Agency_it_temp_request

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Completed 11 March 2020

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