Direct Appointment Request

Name of person to be hired:

Job Title:

Position Number:

Effective Date of Employment:

Please provide a clear justification of the reason(s) for the direct appointment, attaching additional justification/explanation if necessary.

Department requesting direct appointment:

Contact Email:

Extension:

Please notify the individual your department wants to hire directly that we must complete a criminal background investigation before a job offer is extended and in accordance with federal law the new hire must prove identity and legal eligibility to work in the United States prior to or not later than the first day of employment with the University of Kansas Medical Center.

Please provide the individual's resume or CV, full name, and Social Security Number to your Human Resources Generalist. We cannot conduct the background investigation before we receive the signed Applicant Certification Form authorizing us to proceed.

Please have the individual who you want to hire directly sign and provide the Applicant Certification Form to your Human Resource Generalist.

All requests for direct hire will be reviewed by Human Resources and then referred to the Office of Institutional Opportunity and Access (IOA) for final approval prior to hiring.