Employee Manager Offer Request

Employee Manager Offer Request

Requestor / Hiring Manager

Candidate Information

Candidate Name:

Current Address:

Personal Email: Phone:

Position & Offer Details

Requested start date:

Full-time Part-time Temporary Contractor

Exempt Non-exempt

Compensation & Benefits

Contingencies & Pre-Employment Checks

The proposed offer is contingent upon successful completion of the following checks (select all that apply):

Background check Drug screen Reference checks Education verification Right-to-work verification

If additional contingencies or special conditions apply, describe below.

Business Justification

Provide a concise justification for hire including scope of responsibilities, business impact, and whether this is a backfill or net-new position.

Employment History (for verification)

Title: Dates employed (from/to):

Title: Dates employed (from/to):

Education

Graduation date:

References

Phone: Email:

Phone: Email:

Phone: Email:

Legal Declarations, Certifications & Authorizations

Employment-at-will: Unless a written agreement signed by authorized representatives provides otherwise, employment offered to the candidate will be at-will and may be terminated by either party at any time, with or without cause and with or without notice.

Equal Employment Opportunity: The Company is an equal opportunity employer and does not discriminate in hiring or employment on the basis of protected characteristics. Hiring decisions will be made in accordance with applicable law and Company policy.

Hiring Manager Certification: I certify that the information provided on this form is true to the best of my knowledge, that required approvals and budget for this role have been obtained, and that I authorize Human Resources to contact former employers, educational institutions, and references for verification and to conduct required pre-employment screening as indicated above. I further certify that I will not offer any terms to the candidate other than those authorized by HR.

Authorization to Verify: By submitting this form, the Hiring Manager authorizes Human Resources to obtain employment, education, professional references, background checks, and any other verification reasonably necessary to complete pre-employment screening and confirm candidate eligibility.

Approvals & Budget

Headcount approved: Yes

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