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New Hire Information Form
"
*
" indicates required fields
Name
*
First Name
Middle
Last Name
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
- Select -
Male
Female
Decline To Say
Select Your Preferred Pronouns
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She/Her/Hers
He/Him/His
They/Them/Theirs
Not Listed
If 'Not Listed' Was Selected, Please Enter Your Preference
UID #
About Your Position
Position Type
*
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Faculty
Post-Doctoral Scholar
Exempt Regular Staff
Nonexempt Regular Staff
C1/C2 Staff
GA/TA/Hourly Grader
Visiting Professor
Direct Supervisor
Contact Information
Permanent Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
*
Cell Number
*
Email
*
Emergency Contact
Full Name
*
Relationship
*
Email
*
Primary Phone Number
*
Alternative Phone Number
I-9 Authorized Representative Information
(must be someone 18+, someone you trust, and can verify your identity).
Authorized Representative's Name
*
Authorized Representative's Email Address
*
Personal Data
Hispanic or Latino (Check One)
*
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Yes
No
Racial Identity (Select One Or More)
*
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Not Reported
Citizen/Visa Status
*
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US Citizen
Permanent Resident
VISA (J-1)
VISA (H1-B)
VISA (F-1)
Citizenship Country (Use N/A If None)
*
Resident Number (Use N/A If None)
*
Retired From State of MD
*
- Select -
Yes
No
Active Military
*
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Yes
No
Education
Please Select Highest Degree Earned
*
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N/A
Bachelor's Degree
Master's Degree
PhD
If NOT APPLICABLE, Please Fill "N/A" For The Remainder Of The Education Fields
Bachelor's Degree
Institution Where Degree Was Earned
Month And Year Degree Earned
Major/Program of Degree
PLEASE INCLUDE THE FULL TITLE OF THE EARNED DEGREE, IE: BACHELOR OF SCIENCE IN INFORMATION SCIENCE AT COLLEGE PARK (INFOSCI-CP)
Master's Degree
Institution Where Degree Was Earned
Month And Year Degree Earned
Major/Program of Degree
PLEASE INCLUDE THE FULL TITLE OF THE EARNED DEGREE, IE: MASTER OF SCIENCE IN INFORMATION SCIENCE
PhD / Doctorate
Institution Where Degree Was Earned
Month And Year Degree Earned
Major/Program of PhD
PLEASE INCLUDE THE FULL TITLE OF THE EARNED PHD DEGREE
Retirement Plan
New Hire Retirement Selection
Select A Retirement Plan: (Only For Exempt/Nonexempt Regular Employees & Faculty)
*
- Select -
State Employee Pension (required for non-exempt regular Employees, optional plan for Exempt regular employees)
Optional Retirement Plan (ORP)
N/A I am an hourly employee (GA/TA)
Regular Employees & Faculty Select The ORP, Please Select A Vendor
- Select -
TIAA
Fidelity
N/A I am an hourly employee (GA/TA)
File Upload
Resume/CV
Accepted file types: pdf, Max. file size: 10 MB.
Please upload your resume or CV.