New Hire Form | UMIACS Business Office

UMIACS Employee/Visitor Information Form

First name

M.I.

Last name

Email Address Please make sure it is entered correctly

Street Address

City

State

Zip Code

Country

Phone

Sex

Male

Female

Race

Birthdate

Citizenship

Permanent Resident #

Visa Type

Visa Number

Expiration Date

Passport Number

Title

Dates Provide the from/to dates

Institution/Organization

Department

Institution (City/State/Country)	Degree*	Discipline	Date Earned	Honorary Degree
				Yes No
				Yes No
				Yes No
				Yes No