HUMAN RESOURCES/LABOR RELATIONS

REINSTATEMENT REQUEST

Name:	Former Employee SAP ID # (not badge #):

EXACT date you left your former classification:

Former Job Classification:	Former Department:
List of classification title(s) for which you would like to be considered:

Phone Number: Email:

Shift Availability:	Job Availability:	Bilingual?

Day Shift	Full-time	Yes
Graveyard Shift	Part-time(19 or less/wk)	No
Rotating Shift	Part-time(21+ hrs/wk)
Swing Shift	Temporary (6 mo or less)	Language?
Weekend Shift	Intermittent Hourly on call

I understand my name may be referred to all departments including my former department, unless I opt out:

I do not want my name to be referred to the following departments:

Note: Candidates from the Reinstatement lists are contacted at the discretion of the Department. Candidates who highlight their qualifications and skills for the position have an increased chance of being offered an interview. Therefore, we highly encourage you attach a resume to your request. Candidates will not be notified of vacancies. Human Resources will not notify candidates when Reinstatement applications expire.

Final determination as to which classification(s) employees are eligible for Reinstatement requests will be made by the Department of Human Resources.

EMPLOYEE SIGNATURE	DATE

DEPARTMENT OF HUMAN RESOURCES	DATE

______ Approved as requested	______ Approved with changes	______ Denied

__________________________	_______________________ __	_________________________

__________________________	__________________________	_________________________

A REINSTATEMENT consists of placement in a classification in which you formerly held permanent status or to a classification that requires reasonably similar knowledge, skills and abilities to that classification.

Once those classifications into which you are eligible to reinstate are determined, your name will be placed on the corresponding eligible lists. Your name will remain on those eligible lists for one (1) year from the date you left your former classification or until you accept a reinstatement, whichever occurs first.

I understand that I may remain on eligible lists as a reinstatement for up to one (1) year from the date I left my former classification. I also understand that if appointed as a reinstatement, I must serve a new probationary period if I had resigned from my former classification. {Per Section 5.195 of the Washoe County Personnel Handbook.}

ONCE THIS FORM HAS BEEN COMPLETED AND SIGNED

PLEASE SCAN AND EMAIL TO: CAREERS@WASHOECOUNTY.GOV