To add, change, or delete employee information, please complete and submit this form.


* - required field

 

* ADD    CHANGE    DELETE  
*First Name: MI:
*Last Name:
*Department:
*Title:
*Building: *Room: Phone Prefix: 
*Phone Ext.1: Phone Ext.2:
Phone Prefix: Campus prefix (if other than 243)
Phone Ext. 1: personal extension
Phone Ext. 2: department extension
*E-Mail Address:
* Employee Status:
Full Time Permanent
Full Time Temporary 
Part Time Permanent
Part Time Temporary    
Retired
Separated
Remarks: