Request for Reinstatement
First Name  
Last Name  

Please provide the information below as it pertains to the job you held at the time of your separation:

Employee Number
Hire Date  
Separation Date  

10.3 Reinstatement to Eligibility List

Any former Regular Employee separated from the Classified Service in Good Standing may, within two (2) years from the date of separation, apply to the Director to have his or her name placed on the Eligibility List for the Class the employee held at the time of separation. In order to qualify for reinstatement under this Rule 10.3, the applicant must meet any established minimum qualifications for the Class existing at the time of the application for reinstatement. Such request shall be made in writing to the Director, who shall submit his or her recommendation to the Board for review and final approval. Upon review and approval by the Board, the name of the former employee shall be placed at the bottom of the appropriate Eligibility List for the duration of such list. Any person subsequently appointed after being reinstated to an Eligibility List under this Rule 10.3 shall not be deemed a Regular Employee until completion of the Probationary Period. Nothing in this Rule 10.3 shall be construed to interfere with any reinstatement rights under state or federal law, and to the extent this Rule is inconsistent with such state or federal laws, the provisions regarding reinstatement in such laws shall control.

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Equal Opportunity Employer