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EMPLOYEE SIGNATURE DATE TO BE COMPLETED BY EMPLOYEE’S PRESENT SUPERVISOR WILL A REPLACEMENT BE REQUIRED (check one): Yes No Work week schedule (hours, etc.) SUPERVISOR’S SIGNATURE DATE (PRINT NAME) SUPERVISOR’S PHONE NUMBER: Cell: Office: (PLEASE FORWARD TO THE OFFICE OF HUMAN RESOURCES) DATE RECEIVED FOR HIRING DEPARTMENT USE ONLY DATE OF INTERVIEW DISPOSITION REASON FOR DENIAL Approved Superseded Seniority Qualifications Denied Withdrawn Cancellation Lower Rated Classification Recent Bid Other NOTES BY DISTRIBUTION: DATE ORIGINAL-Hiring Unit/Department COPY-Employee COPY-Office of Human Resources, 413 Academy Street 01/2008.