RECRUITMENT REQUEST FORM

Please note required fields are marked with an asterisk (*)

Dept. & Position Information
*	Your Full Name:
*	Your e-mail address:	Your contact information will be used to e-mail a confirmation message.
*	Will this person fill a vacant or soon to be vacant position?	No   Yes    * Name of incumbent:
*	Department:	Business Office Forest Management Communications Group Computing Helpdesk Dean's Office Forest Ecosystems & Society Forest Engineering, Resources & Management Maintenance & Purchasing Forestry Media Center Oregon Forest Education Program Outreach Education Office Student Services Wood Science & Engineering
*	Job Location:
*	Office Location:	Peavy/Richardson  FSL  Remote Site (Off Campus)  Other     Please specify:
*	Supervisor Name:
*	Supervisor Phone Number:
*	Appointment Type:
*	Position Title:
*	Position Appointment Percent:
*	Appointment Basis:	9-Month 12-Month
*	Position Summary: State the purpose of the position and relationship to unit and/or university mission.
*	Position Duties: Include % of time for each duty listed
	Describe scholarly outcomes for position: Academic faculty only
*	Decision Making/Guidelines: Describe the breadth and scope of decisions made by this position. Are decisions reviewed, and by whom? List any guidelines or reference materials used.
	Lead Work/Supervisory Responsibilities: Does this position have any Lead or Supervisory responsibilities?	No    Yes    * Please select all that apply: Plans Work Assigns Work Approves Work Disciplines/Rewards Responds to Grievances Hires/Fires (or effectively recommends) Prepares/signs performance evaluations/reviews None * How many and what type of employees does this position provide lead work for, or directly supervise? * What percentage of time does this position perform lead work/supervisory duties?
*	Is a criminal background check required for this position?	No   Yes
*	Position must possess a valid driver's license:	No   Yes
	Purpose for which driver's license is needed:
*	Additional required qualifications:
*	Preferred qualifications:
*	Job Title (Professional faculty only):
*	Will this position be filled temporarily while search is being conducted?	No   Yes
*	Will this position be filled temporarily to replace a regular employee on leave?	No   Yes
*	Is this search competitive or non-competitive?	Competitive   Non-Competitive    * If non-competitive, name of recommended appointee:
	Justification for non-competitive search:
*	Requested posting date:
	For full consideration date:
*	Closing date:
*	Recommended full-time pay range:
*	What criteria did you use to arrive at this salary?
*	Index?
*	Anticipated appointment begin date:
*	Anticipated appointment end date:
	Search committee: Specify chair and name, gender and ethnicity of each member)
	Advertising sources:
Safety/Working Conditions
*	Operate a University vehicle: (Please select all that apply)	None of these Passenger Vehicle Tractor ATV/Golf/Utility Cart Forklift Heavy Machinery Mower Agricultural Machinery
	Specify other vehicle used:
*	Enter Restricted Areas: (Please select all that apply)	None of these Confined Spaces Radioactive Materials Location Biological Laboratories Carcinogen Laboratories Laser Facilities UV Facilities Magnetic Fields (NMR, etc.) X-ray Facilities Construction Other
	Specify other restricted areas:
*	Work with chemicals in a non-lab setting:	No   Yes
*	Work with lift equipment:	No   Yes
*	Work with hazardous materials: (Please select all that apply)	None of these Toxic Chemicals Radioactive Materials or Instruments Carcinogens Biological Agents Human Body Fluids Compressed or Cryogenic Gases Controlled Substances (Drugs) Lasers X-Ray Machines Other
	Specify other hazardous materials:
*	Work on elevated surfaces:	No   Yes
*	Perform hot work with metal:	No   Yes
*	Work in or over water, or while underway: (e.g. scuba dive, free dive, operator/passenger in boat, lifeguard, water sampling, etc.)	No   Yes
*	Use power tools: (Please select all that apply)	None of these Pneumatic Driven Tools Gasoline Driven Tools Electric Tools Stationary Shop Tools
*	May be exposed to asbestos:	No   Yes
*	May be exposed to high noise levels:	No   Yes
*	Work in area where energy control (Lock-Out, Tag-Out) is required:	No   Yes
*	Perform paint or paint preparation:	No   Yes
	Work in speciality operations area: (Please select all that apply)	None of these Forestry Operations Health Care Environment Ag Chemical Application (pesticides, herbicide) Respirator or Dust Mask use Food Service (prep, washing, dishes, etc.) Work With Small Animals Work With Large Animals
*	Work in a laboratory:	No   Yes
*	Work in an office:	No   Yes
	Lift Objects:	Never   Seldom   Often    * Describe objects and weight:
	Carry Objects:	Never   Seldom   Often    * Describe objects and weight:
	Push/pull Objects:	Never   Seldom   Often    * Describe objects and weight:
*	Flag traffic:	No   Yes
			Please double-check the form and include information for all required fields.