HR Office Support Allocation Form

HR OFFICE SUPPORT ALLOCATION FORM

Request Summary

Requesting Department:   Cost Center:

Date of Request:

Personal Information (Requestor)

Phone:   Email:

Position Information (Support Request)

Department:   Reporting Manager:

Proposed Start Date:   Anticipated End Date:

Requested Hours per Week:   Requested FTE:   Estimated Hourly Rate:

Support Type and Duties

Select support types required:

Administrative assistance    Recruitment support    Onboarding support

Payroll administration    Records management    Training coordination

Clerical / data entry    Other:

Cost, Funding and Duration

Estimated Monthly Cost:   Funding Source:

Employment History (Requestor)

Employer 1

Title:   Dates Employed:

Employer 2

Title:   Dates Employed:

Education

Professional References

Reference 1

Phone:   Email:

Reference 2

Phone:   Email:

Reference 3

Phone:   Email:

Legal Disclosures and Authorizations

At-Will Employment Notice: Nothing in this allocation request, nor any approval hereof, alters the at-will employment relationship between the employer and any employee. Approval of support allocation does not create a contract of employment for a fixed term, nor change employment classification unless expressly documented in a separate written agreement signed by an authorized representative.

Equal Opportunity Statement: The organization provides equal employment opportunity and does not discriminate in employment or allocation of resources on the basis of protected characteristics. Allocation approvals are to be made in a manner consistent with applicable nondiscrimination policies.

I acknowledge the At-Will Employment Notice.

I acknowledge the Equal Opportunity Statement.

Applicant Certification and Authorizations

I certify under penalty of perjury that the information provided in this allocation form is true, accurate and complete to the best of my knowledge. I understand that any material misstatement or omission may be grounds for denial or rescission of the allocation and may subject me to disciplinary action.

I authorize the organization and its authorized agents to contact my previous employers and references for the purpose of verifying employment history and qualifications relevant to this request. I further authorize background checks as required by organizational policy for individuals assigned to HR support roles.

I authorize contact of previous employers and references.

I authorize background checks in accordance with organizational procedures.

Supporting Documentation

Approvals (For Administrative Use)

Manager Approval

Manager Name:   Title:

Approval: Approve   Date:

HR Operations Review

HR Reviewer:   Date:

Approval: Approve

Finance Review

Finance Reviewer:   Date:

Approval: Approve (budget confirmed)

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