Requisition/Referral Form - Agency Temps

Agency

Project Number

Manager/Superintendent

Supervisor / Foreman

First

Middle

Last

Phone

Job Assignment

Hourly Pay Rate

Per Diem Rate

Truck Pay

I confirm that the temp:

Has been informed by me or my designee to report to Hickory, PA for New Hire session (select any day Monday thru Friday)

Select a date to report +

Select a time to report

Has been informed by me or my designee to bring driver license, documents for I-9, direct deposit, truck pay (if applicable)*

Form submitted by

Clicking "Submit" will send this request to the Finance & HR departments and a copy will be sent to the requestor.