The University of Alabama in Huntsville
Temporary Employee Request Form
1.
Email the completed and signed form to Lisa Carter at lcr0003@uah.edu (or fax to 824-6908).
2. An Employment Representative will email or call to confirm receipt.
3. While RUSH orders are
accepted, we appreciate advance notice to identify the best available employ
ee.
Anticipated Start Date: ___________ Anticipated End Date: Account #: ___________
Department: Email Address: ______________________
Ordered by: UAH Phone #: ________________________________
Reason for temp request: Vacant Position Vacation Coverage Medical Leave Special Project
Peak Workload Military Leave Other: ____________________
Hours/Days: Hourly Pay Rate: __________________
No. of Employees Needed: ______ Location:
Temporary employees should report to: UAH Phone #: ________________
Temporary Job Title:
Please check all skills/education that apply:
MS Word MS Excel MS Outlook MS PowerPoint MS Access/Publisher
Data Entry Multi-line phone Copying/Filing Customer Service Shipping/Receiving
Heavy Lifting Custodial Services Grounds keeping Maintenance Programming Skills
Banner Accounting Skills Degree/Certification __________________ Valid Driver’s License
Job Description: ___________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
If you have a person in mind for this position, please include a name and telephone number:
_________________________________________________________________________________________
Additional information: ______________________________________________________________________
Authorized signature: ________________________________ Date: ______________
A representative from Staff Employment will complete the appropriate paperwork and orient the employee before his/her
assignment. At the end of each week, the supervisor should sign the temporary employee’s time card provided by the
temporary agency. Please notify the UAH HR Representative when the assignment has ended. Your department will
incur the
cost for the temporary help based on the UAH salary scale plus a markup (28% effective March 1, 2015).
Sta
ff Employment will automatically submit an electronic bill to the department each week for the temporary employee.
For Human Resources use only:
Temporary Employee Hired: ___________________________________
PCLS: H_______ Log Number: ______________ Hourly Rate: ____________ Bill Rate: ___________
click to sign
signature
click to edit
![]()
