For New Staff Requests:

Equipment Request:

Does Employee need access to the WEX Fuel Card System?

Please provide the RFID number located on the back of the ID Card in order to grant access to agency sites:

Staff Allocation (New Staff Requests and Staff Allocation changes): 

• Will employee be allocated to multiple locations?
  • If yes, Specify which locations:
  • If yes, Specify days at each location and hours:
• Cost Center (Hired-In or Home Dept.):
• Please provide % of work time by Cost Center/Program/Site:

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