Service Desk Entry "*" indicates required fields Step 1 of 14 7% Managerial Information Requestor Name First Last Work Email Phone NumberRegional VP Carlos Rivera Eric Wheeler Jaime Restrepo Edita Gargovic Elgar Quijandria Submission Date MM slash DD slash YYYY Request TypeDepartment* Human Resources Operations / IT Safety HR Category* New Hire Information Re-Hire Resignation/Retire Termination Change of Address Retro Pay Leave of Absence Pay Rate Change Transfer Employee of the Month Uniform Ordering Shoe Reimbursement Employee Relations Operations/ IT Category* Business Cards Email Signature Gift Card ID Badge Safety Category* Accident Reporting This field is hidden when viewing the formNew Hire SectionEmployee Information Employee Name* First Middle Last Date of Birth* MM slash DD slash YYYY Home Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Location / Site*Job Number*Job Title / Role*Pay Rate*Hours per Week*Shift* AM PM Overnight Position Type* New Hire Replacement Employee being Replaced*Last Day of Work for Employee being Replaced* MM slash DD slash YYYY Termination PA Submitted* Yes Not Yet Additional Notes This field is hidden when viewing the formRe-Hire SectionEmployee Information Employee Name* First Middle Last Last 4 SSN*Home Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth* MM slash DD slash YYYY Telephone*Job Location / SIte*Job Number*Job Title*Pay Rate*Scheduled Days to Work* Monday Tuesday Wednesday Thursday Friday Saturday Sunday Scheduled Work Hours*Employment Type* Union Non-Union Position Type* Added Position Employee Replacement Replaced Employee*Last Day of Work for Employee being Replaced* MM slash DD slash YYYY Termination PA Submitted* Yes Not Yet Additional Notes This field is hidden when viewing the formResignation/Retire SectionEmployee Information Employee Name* First Middle Last Employee ID #*Job Location / Site*Job Number*Future Eligibility* Eligible for Re-Hire Do Not Re-Hire Proof of Resignation/Retirement* Drop files here or Select files Max. file size: 50 MB. Additional Notes* This field is hidden when viewing the formTermination Section Employee Information Employee Name* First Middle Last Employee ID #*Job Location / Site*Job Number*Future Eligibility* Eligible for Re-Hire Do Not Re-Hire Additional Notes* This field is hidden when viewing the formChange of Address Section Employee Information Employee Name* First Middle Last Employee ID #*Job Location / Site*Job Number*W-4 Upload*Max. file size: 50 MB. Additional Notes* This field is hidden when viewing the formRetro Pay Section Employee Information Employee Name* First Middle Last Employee ID #*Job Location / Site*Job Number*Date & Hours*DateAmount of Hours Add Remove*if multiple days are being requested, please select the "+" sign for more entries. Additional Notes* This field is hidden when viewing the formLeave of Absence Section Employee Information Employee Name* First Middle Last Employee ID #*Job Location / Site*Job Number*Leave from Date* MM slash DD slash YYYY Leave to Date* MM slash DD slash YYYY Additional Notes* This field is hidden when viewing the formPay Rate Section Employee Information Employee Name* First Middle Last Employee ID #*Job Location / Site*Job Number*Previous Amount*New Amount*Additional Notes* Transfer Section Employee Information Employee Name* First Middle Last Employee ID #*From Job Number*To Job Number*Job Title*Pay Rate*Scheduled Days to Work* Monday Tuesday Wednesday Thursday Friday Saturday Sunday Scheduled Work Hours*Employment Type* Union Non-Union Position Type Added Position Employee Replacement Other Replaced Employee*Additional Notes* This field is hidden when viewing the formEmployee Nomination Section Employee Information Year:*For the Month of:* Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Employee Name* First Middle Last Employee ID #*Job Location / Site*Job Title* Please provide detailed, specific examples for each of the following categories:Quality of Work*(Maintains high cleaning standards)Reliability*(Strong attendance and punctuality)Customer Feedback*(Positive comments from clients or supervisors) Teamwork*(Supports colleagues and fosters a positive environment) Initiative*(Suggests improvements or goes beyond assigned duties) Additional Reasons for Nomination / General Comments This field is hidden when viewing the formUniform Request Section Employee Information *All employees will receive 5 Polos & 2 Vest Job Location / Site*Job Number*Enter Employees Below Order Request Type*New EmployeeRenewalEmployee Name* First Middle Last Employee ID #*Employment Status*Select OneFull TimePart TimeShirt Type*Select OnePolo ShirtT-ShirtShirt Size*Select OneUnisex-SmallUnisex-MediumUnisex-LargeUnisex-(x)LargeUnisex-(xx)LargeUnisex-(xxx)LargeVest TypeSelect OneFleece VestVest Size*Select OneUnisex-SmallUnisex-MediumUnisex-LargeUnisex-(x)LargeUnisex-(xx)LargeUnisex-(xxx)LargeHat TypeSelect OneBaseball CapBeanieWInter Jacket SizeSelect OneUnisex-SmallUnisex-MediumUnisex-LargeUnisex-(x)LargeUnisex-(xx)LargeUnisex-(xxx)Large Additional NotesAdd any relative notes regarding uniforms for this location (ex. special logo required, specialized uniform pieces, etc..) This field is hidden when viewing the formShoe Reimbursement Section Employee Information Employee Name* First Middle Last Employee ID #*Job Location / Site*Job Number*Date of Purchase* MM slash DD slash YYYY Purchase Total Amount*Proof of Purchase* Drop files here or Select files Max. file size: 50 MB. This field is hidden when viewing the formEmployee Relations Section Location where this happened Job Location / Site*Job Number*Union Associated with Employee* 32BJ, New York 32BJ, New England 32BJ, Connecticut 32BJ, New Jersey 32BJ, Philadelphia/Delaware 32BJ, Massachusetts (Local 615) SEIU, Local 6 SEIU, Local, Northern California SEIU, Local, Southern California SEIU, Local 1, Chicago RWDSU UFCW, Local 1102 USWU, Local 74 N/A Employee Name* First Middle Last Describe what happened*Enter as many details as possible Upload any relevant photos or supporting documents here Drop files here or Select files Max. file size: 50 MB. Δ
