Fillable Faculty-information-form JACKSONVILLE UNIVERSITY

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Faculty-information-form JACKSONVILLE UNIVERSITY

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Country of origin: US
File type: PDF

U.S.A. forms for Jacksonville University

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TO BE COMPLETED BY NEW HIRE FACULTY ONLY (FOR ADMIN USE ONLY)
JACKSONVILLE UNIVERSITY JU I.D. #:____________________
□ New Hire Information Sheet
□ Re-Hire Information Sheet
Personal
Last Name: ________________________________ First Name:_______________________ MI:_________
Date of Birth: ________________ Gender: _____ SS#:____________________________________________
Street Address: ____________________________________________________________________________
City/State/County/Zip: _______________________________________________________________________
Home Phone: ___________________________ Cell Phone: _______________________________________
Ethnicity:
□ Black, non-Hispanic □ White, non-Hispanic □ American Indian-Alas □ Asian/Pacific Isl □ Hispanic □ Other □ International
Emergency
Emergency Contact Name: _______________________________ Phone #:____________________________
Address: __________________________________________ City/State/Zip: ___________________________
(Administrative Offices Only below this Line)
Hiring Authority
Start Date: ________________ End Date (if applicable): ______________
Position: ___________________________________ FT or PT: ______________ Salary: _________________
Department: ____________________ Fund Code: ______________ Acct. #: ___________________________
New Employee’s Office Phone Number: _________________________ Fax: ___________________________
New Employee’s Building / Room Number: _____________________________________________________
Replacing: ________________________________________________________________________________
Hiring Authority Name Dept. Ext
ATTACH I-9 and W-4 to this form
Academic Affairs / Faculty
Highest Degree: Type____________________ Date____________ Where_____________________________
Terminal Degree? Yes / No Rank: □Visiting □ ADJ □ Instructor □ Resource □ ASST □ ASSOC □ PROF
CUPA Code: _____________ □ Non-Tenure Track □ Tenure Track □ Tenured
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Faculty-information-form JACKSONVILLE UNIVERSITY

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Completed 9 February 2020

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