Outside Jobs


Name: _________________________________________________________ Division: __________________________ Unit: ________________________ Job Title: _______________________________________________________ Name of Supervisor: ______________________________________________ Secondary Employment Information
Name of Agency/Business: _________________________________________
Address: ______________________________________________________
Phone #: ______________________________________________________
Job Title: ___________________ Specific Duties: ____________________
______________________________________________________________
Work Schedule:	Mon. ____________ Tues. ____________ Wed. ____________ Thurs. ____________	Fri. ____________ Sat. ____________ Sun. ____________ Total Hours per wk: _______
I hereby certify that the above information is complete and accurate to the best of my knowledge, and I request permission to hold employment outside of Cobb County Government.
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Employee's Signature _______________________________ Date ________ Supervisor's Signature: ______________________________ Date ________ Approved ____ Denied ____ If No, Reason: ________________________ _______________________________________________________________ _______________________________________________________________ ____________________________________ _____________________ Tamara George, Director Date