HR Consultant Routing Form

HR CONSULTANT ROUTING FORM

Use this form to initiate engagement of an external consultant. Complete all sections fully and attach required documentation to the routing packet. Submitting this form certifies the accuracy of the information and authorizes review by HR, Legal, Procurement, and Finance for the purpose of evaluating and approving the engagement.

Personal Information

Phone:    Email:

Position & Engagement Information

Requesting Manager:    Intended Start Date:    Intended End Date:

Hours per week:    Compensation (rate or total):    Budget Code:

Classification and Compliance

Classification (select all that apply):  Independent Contractor   Employee / Temp   Other (specify below)

Required documentation attached: W-9 or tax form  Certificate of Insurance  Signed Scope Statement  Other

Employment History (Most Recent)

Title:    Dates Employed:    Phone:

Employment History (Prior)

Title:    Dates Employed:    Phone:

Education

Professional References

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Legal Disclosures & Statements

At-Will / Relationship: The completion of this routing form is an administrative step to request engagement. This form does not itself create an employment relationship. If the consultant is engaged as an independent contractor, no employer-employee relationship, benefits entitlement, or payroll withholding exists unless expressly determined and documented in a separate executed agreement.

Equal Opportunity: The organization is an equal opportunity provider. Selection, retention, and engagement decisions will be made without regard to race, color, religion, sex, national origin, age, disability, or other protected characteristics as defined by law.

Background Check & Authorization

I authorize the organization and its agents to verify information provided on this form, to contact listed references and prior employers, and to obtain consumer or investigative background reports where permitted by law. I understand that any misrepresentation, omission, or falsification of information may be grounds for denial of engagement or termination of any subsequent agreement.

Consent to Background Check: I consent to background checks and verification described above.

Approvals & Routing (Internal Use)

HR Business Partner

Action: Approve   Decline   Printed Name:    Date:    Comments:

Procurement

Action: Approve   Decline   Printed Name:    Date:    PO Required: Yes

Legal Review

Action: Approve   Decline   Printed Name:    Date:    Required Revisions:

Finance

Action: Approve   Decline   Printed Name:    Date:    Funding Confirmed: Yes

Applicant Certification & Authorization

I certify that I have provided true, accurate and complete information on this form. I acknowledge that any material misrepresentation, omission, or falsification may be grounds for denial of this engagement request or termination of any subsequent engagement. I authorize the organization and its authorized agents to contact prior employers, references, and other entities to verify information necessary to evaluate my suitability and eligibility for the requested engagement.

Consent to Terms: I certify the statements above and authorize verification.

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