Staff Request Form
DR#                 Date of Request :
Request for Individual Workers
To complete these tasks: During these hours How many workers? Where do these works report? For how many days? First day workers needed Who do they report to? works
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Printed Name and Signature of Person Submitting Request Date Requested E-Mail Address used on this DRO
Requestor’s Position DRO Phone Number Work Location
Approver Name & Signature Approver’s Position Approver DRO Phone Number

*Training Required? Yes No If yes, date, time, & location:
Staff Services Only:
Date & Time Received in Staff Services: Volunteer Connection Data Entry:
Date & Time: SS Worker’s Name:
DCS JT DMWT Staff Request Form V.0.1
[HTML V 1.0 American Red Cross Gold Country Region 2017