This form is to be completed by the hiring manager after the screening of applications has been completed. Please return the completed form, your screening sheet and any supplemental documentation to Human Resources. This form can be waived if HR receives an email containing the information required.
SECTION 1 – Position Information
Position Number:	Hiring Manager/Panel Chair:
SECTION 2 – Interview Selection
Please list a minimum of three (3) candidates selected for interview:
Candidate 1:	Candidate 7:
Candidate 2:	Candidate 8:
Candidate 3:	Candidate 9:
Candidate 4:	Candidate 10:
Candidate 5:	Candidate 11:
Candidate 6:	Candidate 12:
Panel Member Names: (Panels are recommended when filling supervisor-/management-level positions.)
Panel Member 1:	Panel Member 2:
Panel Member 3:	Panel Member 4:
List Possible Dates, Times and Locations for Interviews:
Date	Time	Location
Please remember to attach your screening sheets with a “key” as to how applicants were evaluated. If multiple screening sheets exist, please summarize your conclusions. You will be notified after all candidates have been scheduled. If you have any questions, please call Human Resources.