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Date: _ /_ /_____ PURDUE UNIVERSITY MENTAL, PHYSICAL, AND ENVIRONMENTAL POSITION SPECIFICATION FORM Date: _ /_ /_____
PURDUE UNIVERSITY
MENTAL, PHYSICAL, AND ENVIRONMENTAL
POSITION SPECIFICATION FORM
The purpose of this form is to identify and document the mental and physical demands and the environmental
factors required for administrative/professional and clerical/service positions.
If the position is being revised or updated, the incumbent should complete the form, if the position is new, it
should be completed by the supervisor.
Identify only those physical requirements and mental skills and abilities that are absolutely necessary to perform
each function of the position.
MACHINES, TOOLS, EQUIPMENT AND ELECTRONIC DEVICES
Please list the machines, tools, electronic devices, or other equipment necessary to perform the job.
1.

6.

2.

7.

3.

8.

4.

9.

5.

10.

PHYSICAL REQUIREMENTS
From the list of physical requirement descriptions below, check the box that best describes the physical
requirements of the position.
1.
[ ] SEDENTARY ACTIVITY: Lift and carry up to
10 lbs. occasionally; sedentary work involves
sitting most of the time.
2.
[ ] LIMITED PHYSICAL ACTIVITY: Lift and carry
up to 10 lbs. frequently, and up to 20 lbs.
occasionally.
3.
[ ] LIGHT PHYSICAL ACTIVITY: Lift and carry 10
to 25 lbs. frequently, and up to 40 lbs. occasionally.
4.
[ ] MODERATE PHYSICAL ACTIVITY: lift and
carry 25 to 50 lbs. frequently, and up to 60 lbs.
occasionally.
5.
[ ] HEAVY PHYSICAL ACTIVITY: Lift and carry
50 to 80 lbs. frequently, and up to 100 lbs. or more
occasionally.
* Occasional is defined as < 50 percent of the time
** Frequent is defined as > 50 percent of the time
___________________________________________________________________________________________________________________________________
For Personnel Services Use Only
Position Title:
Department Name and Number:
Position Classification Code: Position Number: ENVIRONMENTAL AND HAZARDOUS CONDITIONS
Check the boxes that best describe the environmental conditions of the job.
1.
[]
Work Indoors (% of time _(
2.
[ ] Work Outdoors (% of time ____________)
3.
[ ] Respiratory Conditions: Involving exposure to:
[ ] Noxious Fumes
[ ] Dust
[ ] Odors
[ ] Gases
[ ] Inadequate Ventilation
[ ] Other Conditions (List)

4.
[ ] Skin Conditions: Involving exposure to:
[ ] Radiation
[ ] Toxic Chemicals
[ ] Burns
[ ] Electrical Shock
[ ] Other Conditions (List)

5.
[ ] Hazardous Conditions: Including a variety of physical conditions such as:
[ ] Heavy Machinery
[ ] Moving Objects
[ ] Vibration
[ ] Proximity to Moving Mechanical Parts
[ ] High Voltage Electricity
[ ] Infectious Diseases
[ ] Working on Scaffolding and High Places
[ ] Extreme Cold (temperatures below 32«»
[ ] Extreme Heat (temperatures above 90«»
[ ] Steam Pipes and/or Tunnels
[ ] Biological and/or Chemical Agents
[ ] Noise (work requires employee to shout to be heard)
[ ] Cramped working quarters
[ ] Use of sharp objects: surgical/laboratory instruments, knives, needles, food slicing equipment, etc.
[ ] Handling or maintaining animals
[ ] Other hazardous conditions (List)
MENTAL DEMANDS
For each of the mental demands listed below, check the box that best describes the frequency spent utilizing
learned mental skills, and/or working under conditions that require mental discipline.
NOT
DAILY TO
WEEKLY TO
LESS THAN
MENTAL DEMANDS
REQUIRED
WEEKLY
MONTHLY
MONTHLY
CONSTANT INTERRUPTIONS
: Ability to
[ ]
[ ]
[ ]
[
]
work with frequent interruptions.
PLANNING
: Ability to mentally formulate,
[ ]
[ ]
[ ]
[
]
or devise a plan to achieve an end result.
PROBLEM SOLVING
: Ability to define a
[ ]
[ ]
[ ]
[
]
problem, identify the relevant factors,
and formulate a logical solution.
REPETITIVE WORK
: Ability to perform a task
[ ]
[ ]
[ ]
[
]
repeatedly from memory.
READING (documents or instruments)
: Ability
[ ]
[ ]
[ ]
[
]
to learn and/or comprehend instructions and
materials read.
STRESS
: Mental or bodily tension resulting
[ ]
[ ]
[ ]
[
]
from physical, chemical, or emotional factors.
REASONING
: Ability to think through the
[ ]
[ ]
[ ]
[
]
consequences of a decision.
TALKING
: Expressing or exchanging ideas
[ ]
[ ]
[ ]
[
]
by means of the spoken word.
ADDITIONAL COMMENTS




Incumbent's Signature
Date
Supervisor's Signature
Date

Send completed Specification Form with the Position Description and Clerical/Service Questionnaire (if applicable) to
Personnel Services.