Position Filled-Accepted Form
This form must be filled out after the interviews have been conducted, and a person chosen to
fill the vacancy. Please return to Personnel Office after completed. THE JOB FILE WILL NOT
BE CLOSED UNTIL THIS DOCUMENT IS RECEIVED.
Position Title _________________________________________________________________
Replaces ___________________________________________________________________
Total Male Applicants: __________________________
Total Female Applicants: _____________________________
# of Interviews: ___________________ # Offered & Declined Position: __________________
INTERVIEWED
DEGREES
REASON OPTION #
Please select one of the nine (9) options from the table below for each applicant that was not
selected. Always use the most specific reason.
REASON FOR NON-SELECTION
Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
Option 7
Option 8
Option 9
Internal Candidate Selected
Position Closed
No Call/No Show
Salary Offer Refused
Refused to Work Shift/Overtime
Better Qualified Applicant Selected
Applicant Withdrew
Didn’t Meet Job Requirements
Insufficient Experience
Applicant Hired _______________________________________________________________
Date Offered __________ Date Accepted ___________ Employment Date ____________