Please use this form to initiate the recruitment process for all new and existing staff. Please complete all questions.

1. Today's Date:*

2. Requesting Department:*

A department contact will be needed to work with Human Resources to provide general information for the job bulletin and supplemental application, and to develop testing components and rating panels.

3. Who should we contact about this recruitment?*

4. What are you requesting?*

Personnel Recruitment

List Request

5. Class Title Being Requested:*

6. Number of current vacancies:*

7. Date(s) became vacant:*

8. Number of positions in class:*

9. The list will be used for:*

Promotional Full-time

Permanent Part-time Extra-help

10. Budget Line Item:*

11. Please explains the reason for the current vacancy:*

ADVERTISING INFORMATION:

Please indicate the advertising levels desired:

12.A - Standard Advertising?*

Yes No

(Standard Advertising includes listing of title, salary, and recruitment deadline in weekly issue of the Mariposa Gazette.)

12.B - Additional Advertising?*

Yes No

If YES to 12.B, please list additional media sources, e.g., Modesto Bee, Madera Tribune, Sierra Star (Oakhurst/Madera County newspaper), Merced Sun-Star or other (if any) which will effectively and efficiently reach qualified applicants. (Advertising costs will be billed back to the requesting department.) Please remember that if specialized skills are required, mailing lists, newsletters and trade publications are often the most effective in reaching qualified applicants than newspaper want ads.

List Additional Advertising media:

12.C - Other Government Agencies?

Yes No

If YES to 12.C, please specify which cities, counties, or state agencies.

12.D - Special Mailings?

Yes No

If YES to 12.D, please specify which mailing lists below (may be developed from membership rosters of trade organizations, professional organiztions, lists of license or certificate holders, lists of public and private agencies engaged in the specialized activity) and provide typed, gummed mailing labels.

13. Indicate number of weeks for the filing period (this may be dependent on the media you select and their copy deadlines and publication dates.)*

2 3 4 5 6 7 8 9 10

14. Indicate the type of recruitment:*

Continuous Open until filled