New Hire Request & Documentation

Today's Date

mm/dd/yyyy

Employee Start Date

mm/dd/yyyy

Anticipated End Date

If this position is ongoing please leave it blank.

mm/dd/yyyy

Is this Position Grant Funded?

Supervisory Org (Dept & Manager)

Direct Supervisor

Who will this person report to? Please only add if it is different from the Supervisory Org.

Position Type

Non-Staff - (temp,visiting scholar, student worker(not work-study), co-op etc.)

Non-Staff - Work Study Student

Affiliate Worker - Uncompensated

Job Title

Candidate First & Last Name (Legal Name)

Candidate Email Address

Foreign National Part 1

Is this employee a foreign national? If yes, please also answer Part 2 below. Please Note: ALL non-postdoc J-1 Visiting Scholars and Student Interns are required to either purchase a pre-selected J-1 Insurance Plan from Garnett-Powers at: http://www.garnett-powers.com/vs/upenn/ or waive out of the coverage requirement by submitting insurance to Garnett-Powers at http://www.garnett-powers.com/vs/upenn/waiver/ -For Postdocs, please consult the Biomedical Postdoc Program for policies: https://www.med.upenn.edu/postdoc/

Foreign National Part 2.

If you selected Yes on Part 1, please also answer the following questions: 1. Is the employee already in the United States? 1A. If yes, what is the Visa type and expiration date? 1B. If no, what type of visa is expected?

Expected Salary

Costing Allocation

Please add Costing Allocation: (ORG)-(FUND)-(PROGRAM)-(CREF)

Requested By

Your email here please. If you need an email address added please contact Dena Paffas (dpaffas@upenn.edu).

Additional Notes?

Attachments

Please attach the required documents for all worker types: 1. Proof of approval for this position from the CFO 2. The employee’s completed “Personal Information Form” 3. Signed offer letter 4. Completed Confidentiality Agreement & Voluntary Self ID 5. Hiring Exception Approval (only if during a hiring freeze)

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