| COMMENTS |
Enter
comments sufficient to briefly explain this action! |
| Comments |
Enter text of comments. |
| ADDRESS
(Name/Address) |
|
| Name (Last,First M) |
Enter the employee’s name in
the following format: LAST,FIRST MIDDLE |
| Home Address, City, State, Zip+4
or Postal Code, Country |
Enter as appropriate. Country
defaults to USA. |
| PP (Personal
Profile) |
|
| Highest Education Level |
Enter the highest education
level. |
| Full Time Student Yes o No o |
Check the appropriate box to
indicate whether or not the employee is a full-time student. |
| Waive Data Protection Yes o No o |
Check the appropriate box to
indicate whether or not the employee desires to release personal data to the Campus
Directory (assumed to be No unless indicated otherwise). |
| Home Phone |
Enter the home phone
number (including area code). |
| Gender Female o Male o |
Check the appropriate box to
indicate the employee’s gender. |
| E-Mail |
Enter the email address the
University may use in attempting to contact the employee. |
| ELI/ID
(Eligibility/Identity) |
|
| Birthday (mmddyyyy) |
Enter birthdate. |
| Citizenship Status |
Enter the citizenship status. |
| Ethnic Group |
Enter the ethnic group. |
| Military Status |
Enter the military status. |
| Employment Eligibility: Date
Verified |
Enter the date the I-9 Form was
verified (mmddyyyy). |
| Social Security # |
Defaults from page 1. |
| DIS
(Disability) |
Use only
as necessary! |
| Disabled o
|
Click on this box if the employee
is disabled. |
