TEMPORARY STAFFING REQUEST FORM

1.	About the Requester Requester Entity*

6.	Would you like the agency to contact the requestor or work directly with a specific Hiring Manager?

If agency is to work directly with a hiring manager, please provide the contact information below, otherwise, this section can be left blank.

Hiring Manager Name:
Hiring Manager Phone Number:
Hiring Manager Email Address:
Hiring Manager Title:

Will this be Full Time or Part Time?

	Full Time
	Part Time

Detailed Job Information:*

Job Title:
Department Name:
Hours Requested (start time/end time):
Number of Staff Needed:

14.	Principal Duties and Responsibilites:

15.	Additional Requirements of the Position:

18.	Vendors have been instructed to respond to requests within two (2) business days. If you have different requirements for response, please outline those here:

About the Services

Would you or the Hiring Manager prefer to review resumes?

	I would
	Hiring Manager

Would you or the Hiring Manager prefer to interview candidates?

	I would
	Hiring Manager

21.	Please include any additional information that you would like the vendor to consider here: