RESEARCH PERSONNEL NEW HIRE FORM
RESEARCH PERSONNEL NEW HIRE FORM
Please use this form to generate information for hiring a staff member who will be salaried by sponsored research funds.
POSITION/TITLE
*
EMPLOYEE NAME
*
First
Last
EMPLOYEE ADDRESS
*
Street Address
Address Line 2
City
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State / Province / Region
Postal / Zip Code
United States
Country
DEPARTMENT
*
OFFICE/LABORATORY LOCATION
OFFICE/LABORATORY TELEPHONE NUMBER
-
###
-
###
####
COST CENTER/GRANT 7-DIGIT ACCOUNT NUMBER
*
EMPLOYMENT STATUS
*
FULL TIME
PART TIME
ONE-YEAR
TEMPORARY
START DATE
*
/
MM
/
DD
YYYY
Please provide any notes if needed regarding start date.
END DATE (if temporary)
/
MM
/
DD
YYYY
DO YOU WISH THE OFFER LETTER TO BE EXPLICIT ABOUT THE 3-MONTH PROBATIONARY PERIOD POLICY?
*
YES
NO
BASIS OF APPOINTMENT
*
12-MONTH
9-MONTH
OTHER
ADMINISTRATIVE/PROFESSIONAL?
12-MONTH
9-MONTH
OTHER
PROPOSED SALARY RANGE (only include if position is administrative/professional)
STAFF?
12-MONTH
9-MONTH
OTHER
HOURLY RATE (only include if staff)
HOURS PER WEEK (only include if staff)
PAY GRADE (only include if staff)
BENEFIT ELIGIBLE?
*
YES
NO
IF YES:
MEDICAL
PENSION
DENTAL
LIFE & LTD
OTHER
(Please Note: Dental and Life & LTD Benefits have delayed start dates.)
ARE THERE TEACHING RESPONSIBILITIES WITH THIS POSITION?
YES
NO
OTHER
SUPERVISOR/PRINCIPAL INVESTIGATOR
*
DEPARTMENTAL CONTACT AND TELEPHONE NUMBER
PLEASE PROVIDE BRIEF JOB DESCRIPTION
*
PLEASE ATTACH RESUME
*
ACKNOWLEDGEMENT AND ELECTRONIC SIGNATURE REQUIRED:
By checking this box, I confirm that I have reviewed Haverford College’s Hiring Procedures, including information about appropriate employee title and salary band.
*
I agree
I do not agree
Date
*
/
MM
/
DD
YYYY