New Hire Information New Hire Information Request Personal Information Due to Federal educational law concerning the privacy of educational records, the department will correspond with you at your University email address. Last Name * Family name. First Name * Middle Name Chosen Name What you prefer to be called. University ID (UNID) u1234567 Date of Birth * Month/ Day/ Year Telephone Number * (xxx) xxx-xxxx Email * Preferred University Email Employment Status, select one. * Alien TemporaryCitizenPermanent Resident Utah Physical Address Street Address * 123 Lincoln Street, Apartment A City * Salt Lake City State * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * 84112 Emergency Contact Name * Relationship * Telephone * (xxx) xxx-xxxx Street Address * 123 Lincoln Street, Apartment A City * Salt Lake City State * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * 84112 Identity Information Gender * FemaleMaleUnknown Martial Status * SingleMarriedCivil PartnerCivil Partner; Deceased.Married; Separated.DivorcedWidowedHead of HouseholdUnknown Highest Education Level * Associate DegreeBachelor's Nursing (BSN)Bachelor's Level DegreeDoctorate (Academic)Doctorate (Professional)High School Graduate or EquivalentLess Than High School GraduateMaster's Nursing (MSN)Master's Level DegreeNot IndicatedPost-DoctorateSome CollegeSome Graduate SchoolTechnical School Ethnicity (optional): Are you Hispanic or Latino? Yes No What is your race? (Select one or more._ American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander White reCAPTCHA If you are human, leave this field blank. Δ
