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EMPLOYEE REFERRAL AWARD INFORMATION FORM

Please complete the form. Turn completed form and candidate resume into Human Resources for processing.

To Be Completed by Referring Employee


Date

York Employee Information


Name Phone Number Office Location

Referred Candidate Information


Position Title Name Telephone Number E-mail Address Comments

For Office Use Only


Hiring Manager Name Date of Hire Notes Award Amount
(after 3 months of service)

Hiring Manager Title

Award Pay Date

Date HR Received __________________ Processed By: ____________________________________

Revised jg41411

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