05/16/06
Trades & Light Industrial 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)
Equipment:
Jack Hammer
Backhoe
Voltmeter
Industrial Forklift
Oscilloscope
Ohmmeter
Industrial Truck w/bucket (boom platform or other lifting device)
Computer
Other
Skills and other requirements:
Plumbing
Machinist
Valid KS Driver’s License
Electrical
Masonry
Lifting
HVAC
Painting
Inventory
Carpentry
Sheet Metal
Shipping/receiving
Custodial Work
Welding
Locksmith
Landscaping/grounds maintenance
OHR AUTHORIZATION
OHR Signature
Date
Temp Agency
Contact person
Phone
Temp Employee's Name
Start Date:
Classification:
$
per hour
Screening: DMV SOF
Original: OHR Copy: Hiring Department
Special Requirements:
Other:
Authorization:
Date:
Supervisor Signature
Authorization:
Date:
Budget Officer Signature
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