* Request being made by:               

* Today's Date:     (MM/DD/YY)

* Your Extension:

New Hire Information

* First Name:                 

* Last Name: 

Job Title:        

Building/RM:  

Phone Extension:   

* Is this Person transferring from another campus ? 

Yes    No

* Employee Classification:    Make a selection Temporary Non-Faculty Athletic Specialist Instructional Faculty OSO Instructional Faculty OYO Service Faculty OSO Service Faculty OYO MAT PSA Crafts Executive Public Safety/ Building & Grounds Temp Hourly Instructional Active Retiree Skill Center Maintenance & Operations Evening Instructional Contract Contract Pay Resident Faculty Temp Hourly Non-Instructional Service Resident Faculty Specially Funded

Start Date:    (MM/DD/YY)

* A computer:        Yes    No 

* A new Phone:      Yes   No

* New Voicemail account:    Yes    No

* Long Distance Auth Code: Yes      No

Novell     Blitzmail   Memo SWSC

Moving From:     

Moving To:          

Will a voice mail account need to be moved:  Yes      No

To what extension: 

* Last 4 of SSN: 

* DOB:               (MM/DD/YY)