Employee Request Form

First Name *

Last Name *

Department *

Email Address *

I want to submit: *

Staff Meeting Question

Please enter your question for the staff meeting here: *

IT Help

Please describe what you need help with: *

Where are you located today? *

Preferred method of contact:

Phone Extension

Please select the level of urgency for your IT need:

Data Request

Please select the level of urgency

Please describe the data you need. Be as specific as possible about parameters to include, time frame of data needed, etc.: *

Select the date by which you need this data. Please try to allow at least two business days for data requests to be fulfilled. * +

Housekeeping/Maintenance Need

Please tell us what housekeeping/maintenance need you observed - be as specific as possible about location. *

Please select the level of urgency for this housekeeping need:

Supply Request

Please list the office supply/supplies or items that you need: *

Extra Mile Shout Out

You caught someone doing something great! Yay!

Who are you shouting out (employee name): *

Tell us how they went the extra mile: *

I Have A Suggestion/Idea

It takes all of us working together to make Senior Services great! New ideas about ways we can meet our mission, work more efficiently, build our team, have fun, learn and grow together are always appreciated! Please share your idea/suggestion below: *

Mission Moment/Story

We're excited to hear any feel good, warm and fuzzy story that exemplifies our mission in action and shines a light on how we care for each other, seniors we serve, and the community! Tell us about your "mission moment" below - remember to be as specific as you can about who was involved, the impact made, why it touched you, etc. *

Do you have a picture to accompany this story? *

Yes

No No

Do you have permission to share this story? *

Yes

No No

Would the people in this story mind being contacted for additional information or follow-up? *

Yes

No

I'm not sure

Not applicable Not applicable

Please provide their contact information if you know it (name, phone, email, address, etc.):

Community Engagement Report

Event Name/Group Affiliation *

Name of Event Contact:

Event Contact Phone Number:

Email Address

Location of Event: *

Date of Event: * +

Time of Event: *

List all Senior Services staff who attended: *

Type of Event (please check all that apply): *

What did you do at the event? *

Aprox. Number of Event Participants: *

Aprox. Number of People Who You Engaged With: *

Aprox. Number of Directories Distributed: *

Give a general description of topics covered: *

Please share any additional notes here (special contacts made, any follow-up needed, etc): *

Would you recommend Senior Services attend this event in the future? *

Yes

No

Maybe: Maybe:

Employee Business Operations/IT Set-Up (or Termination) Request

Is this a: *

New Position

Existing Position (please indicate who this person is replacing)

Employee Termination (remove from system) Employee Termination (remove from system)

New/Exiting Employee First and Last Name: *

Job Title: *

Any credentials/initials that should go with this person's name (RN, LPN, MSW, etc.)

Department *

Start Date: * +

Termination Date: * +

Did the title of this position change? *

Yes, title was updated (please update org chart)

No, same title as previous position

Is this position already on the organization chart? *

Yes, it is already on the org chart

No, the org chart needs to be updated

I'm not sure

What equipment will this person need? *

What IT set-up will this employee need? *

Please indicate which files/folders this person will need access to on the server (SSMISC, Media Drive, Shared program/department drives)? *

Please check the email distribution lists on which this person should be placed? *

Does this person need access to a previous (or current) employees inbox for monitoring/back-up purposes? *

No

Yes (indicate whose box they need to monitor): Yes (indicate whose box they need to monitor):

Does this person's email need to be forwarded to another employee for monitoring/back-up purposes? *

No

Yes (indicate which employee(s) need access to monitoring the inbox): Yes (indicate which employee(s) need access to monitoring the inbox):

Please indicate where this person will be located (use cube/office number from picture above or describe location):

What operational set-up will this employee need? *

Any other notes for IT/Bus Ops staff?

ThankView Request

Name Your Campaign: *

What type of campaign are you sending? *

Upload Your List of Contacts (use ThankView template document):

Help us build your ThankView email!

This is the content that will appear in the actual email people receive and open.
See below for an example.

Name that should appear in the "From" field (our default is Senior Services, Inc.) but you can customize to read your name or someone else's... *

Default is fine

Customize (insert name): Customize (insert name):

Insert email address(es) replies should be sent to: *

Subject Line for your ThankView email: * 🛈

Would you like to use "merge fields" in your ThankView email? *

Please select which merge fields you'd like to include: *

Compose your email message, be sure to tell us where the merge fields should go. For example:

"Hi [First Name] [Last Name],

We appreciate your [consecutive years of giving] and especially your last donation made on behalf of [company name]. Etc. Etc.

Thanks, *

0/5000 characters

Help us build your ThankView envelope!

This is the envelope that appears in the email message and leads to your video.
We can make limited adjustments to its appearance to suit your needs.

Here are the formatting options. Please select your preference: *

What would you like as your envelope greeting/salutation: (ex: Hello, Good morning, Thank you) *

Please select which structure you'd like for the recipient name on your envelope: *

Compose the additional text that should appear on your envelope: *

Help us build your ThankView Landing Page!

This is the content people will see after they click on the envelope in your email.
It's where they'll see the video.
You can also add a message to display beneath it.

See example below.

Compose your landing page message. Keeping it short (just a few sentences) will help with the appearance of your page. *

0/1500 characters

Do you want your landing page to have a button with a link to a webpage? *

No, I don't need/want to link anywhere

Yes, add a button. Include URL: Yes, add a button. Include URL:

What should your "button" say? Think about what might entice people to click...

Examples: Donate Now! Learn More! Stay Connected!

*

Which "Action Buttons" would you like to include on your landing page? This will give recipients an option to interact with your message. *

Reply with a video recording

Reply with an email

Save your video