Revised Sept 2018
This form is required for all vacancies and is used to facilitate the appropriate approvals before a position is posted.
Please contact firstname.lastname@example.org if your position has not been reviewed in the past five (5) years or has changed
since it was last posted or evaluated.
Retirement, Resignation or Termination
Authorized Leave of Absence*
Position # (if applicable):
If this is a Temporary Full-time position, please complete one of the two fields below:
There are are no changes to the Job Fact Sheet since it was last posted
or evaluated (if you are unsure, contact email@example.com).
Reason for Vacancy:
Examples: parental leave, personal leave of absence, salary deferral, educational leave, long term
disability, short term disability or sick leave, etcetra.
Covering position #:
Project or Program Name:
Name of previous incumbent:
If applicable, list the exiting employee’s last day with pay (MM/DD/YYYY):
**DOWNLOAD before populating this form or you will lose your work!
Section 1 – Position Information
Qualifying Information (check one):
REQUEST TO HIRE FORM - NON-ACADEMIC
8-9-10 Month Continuing (Full-time)
Changes have been made to the Job Fact Sheet (which are highlighted or marked with