DEPARTMENT OF ECONOMIC OPPORTUNITY
SELECTION DOCUMENTATION
POSITION NUMBER:
CLASS TITLE:
LOCATION:
The appointing authority may utilize the selection modules listed below. Please indicate which of the following selection modules were used for this position and attach copies where appropriate:

Application Review (mandatory)	Interview (not mandatory but recommended)

Reference Checks (mandatory)	Supplemental Application (optional)

Work Sample (optional)	Willingness Questionnaire (optional)

Assessment Center (optional)	Test (optional)

Attach a copy of the selection criteria as determined by analysis of the position description. The position description should include up-to-date duties and the knowledge, skills, and abilities needed to perform those duties.
Name of selected applicant and explanation of selection decision:

Please list names and titles of all persons administering the selection process or participating in making selection decisions.
Name	Title	Participated In
1.
2.
3.
4.
5.
PREPARED BY:
DATE:

DEO Form HRM-16 (08/11)

AGENCY FOR WORKFORCE INNOVATION

J0JEM

2001-02-26

mcgillj

FDLES J&B OIT