Reset Form
Please send all forms to
employment@wichita.edu
Contract Labor Requisition Form -- Individuals who are hired through, and are employees of, the temporary
agency per contract with the State of Kansas.
Classification/Position Title: Date:
Department Name:
Supervisor's Name: Department #:
Begin Date:
End Date: Hours Per Week:
Department Box #: Tele. Extension:
Do you want to interview candidates prior to agency placement?
Yes
No
Job Summary (Describe the duties and responsibilities of the job. Include any license or certifications
that may be needed. **BACKGROUND CHECK IS REQUIRED**):
Date:
Date:
OHR USE ONLY
Minimum Education Required:
Minimum Experience Required:
Work Schedule:
Preferred education, experience, or skills:
Physical Requirements:
APPROVALS
Supervisor Signature:
Budget Officer Signature:
OHR Signature:
Temp Agency:
Temp Employee's Name:
Start Date:
Pay Rate:
Bill Rate:
Date:
Phone:
Contact Person:
Screening: DMV
SOF
