New Recommendation for Postdoctoral Appointment for Weinberg College

Postdoctoral Candidate Information

Postdoc Last Name*

Postdoc First Name*

Appointee's email address*

Country of Citizenship*

Visa Required?*

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Doctoral Degree Award Date*

MM/YYYY

Doctoral degree(s)*

Please list all

Employee ID# (Required for all reappointments)

Appointment Information

School/Center*

Enter the Northwestern school or center. "Weinberg College" is the default value here, but you may modify it as needed.

Department*

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Appointment Start Date*

MM/DD/YYYY

Appointment End Date*

MM/DD/YYYY

Postdoc Faculty Mentor*

Please enter in the following order: First-Name Last-Name

Please indicate whether the appointee been a postdoc for more than 5 years.*

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Action Requested*

New Appointment (minimum one-year appt term)

Salary Adjustment

Reappointment (only within same job code)

Transfer to Grant/Fellowship including NRSA

Change of Dates

Transfer from Department/Center

Graduate Student continuing as Postdoctoral Fellow (if term is less than one year)

Other

Job Title (Job Code)*

Postdoctoral Scholar (100006)

NRSA Postdoctoral Fellow (100091)

Postdoctoral Fellow - Dept of Education (105565)

WCAS Research and Teaching Postdoctoral Fellow (100118, formerly Mellon Postdoctoral Fellow)

Postdoctoral Fellow, Direct Fellowship (107021) - Please fill out sponsoring entity below

Visiting Postdoctoral Fellow (103073) - Must have documentation of appointment to a home institution outside Northwestern where they will return

Please attach a CV and any other applicable documentation*

A CV is required for all new appointments and for all reappointments. Letter of Affiliation is required for Postdoctoral Fellow, Direct Fellowship (107021) and Visiting Postdoctoral Fellow (103073)

Drag and drop files here or

Postdoc Copy of CV attached*

Confirm CV is attached by checking box

Confirm Full-Time Appointment (Part-time appointments are not permitted)*

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Source of Funds

Funds must add up to the University minimum.

University Funds 1 ($)

Enter Sponsored or Non-Sponsored funding. Required unless request is for a Visiting Postdoctoral Fellow appointment

University Funds 1 (enter funding chartstring for $ amount above)

Required unless request is for a Visiting Postdoctoral Fellow appointment

University Funds 2 ($)

Enter Sponsored or Non-Sponsored funding.

University Funds 2 (enter funding chartstring for $ amount above)

External Support ($)

This is support not administered by Northwestern University.

Pay

Total New Salary for this appointment

Please enter a monetary sum that includes ALL sources. Please don't include $ symbol. Required unless request is for a Visiting Postdoctoral Fellow appointment

Previous Northwestern Salary, if any ($)

Affiliate Organization

For example: NMH, RIC, etc.

Insurance and University Policies

Please select the checkbox to indicate you agree to the insurance statement.*

Faculty members and administrators must review with the postdoctoral candidate enrollment information for University health insurance, proof of health insurance, or information and approval of coverage by the Office of Risk Management covering the full appointment term. (Refer to pg. 2)

Please select the checkbox to indicate you agree to the University policies statement.*

Postdoctoral Fellows must adhere to University policies on Conflict of Interest, Research Integrity, and Intellectual Property and Patents. The candidate has been informed of these and will be provided with a copy of relevant policies and the staff handbook. https://www.northwestern.edu/coi/index.html

Authorization

I authorize this appointment and certify that the proposed position is in accord with University policies. The Department/Center takes full responsibility for the appointee, including provision of facilities/equipment and any involved obligation of salary, benefits and health insurance claims.

Principal Investigator*

Please enter in the following order: First-Name Last-Name

Sponsoring Principal Investigator Email*

Important note: This email address will be used in an automatically generated request for an approval from the Principal Investigator. Must be Northwestern email address. We recommend you verify the email address in the Northwestern People Directory: https://directory.northwestern.edu/?verbose=1

Dept Chair, Division Chief, or Center Director*

Please enter in the following order: First-Name Last-Name

Dept Chair, Chief or Director Email*

Important note: This email address will be used in an automatically generated request for an approval from the Department Chair/Center Director. Must be Northwestern email address. We recommend you verify the email address in the Northwestern People Directory: https://directory.northwestern.edu/?verbose=1

Requester's Name*

Please enter in the following order: First-Name Last-Name

Requester's Telephone Number

Requester's Email Address*

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