New Employee Data Form : STAR Park : Texas State University

Company Name *

Job Title *

Legal Name *

Full name (First, Middle Initial, Last)

Preferred Name, if applicable

Home Street Address *

City *

State *

Zip Code *

Primary Phone *

Primary Email Address *

Date of Birth *

Name *

Relationship

Emergency Phone Number *

Do you need access to book conference rooms? *

Room and/or Lab numbers *

Do you need access to STAR Park Ricoh copy machine(s)? *

Yes

No

Provide a 4 digit personal code to access the Ricoh copy machine(s)

Name of person granting authority for access and keys *

Email address for person authorizing access *

Do you have a Net ID? *

Yes

No

What is your Net ID? *

What is your Texas State ID Number? *

AXXXXXXXX

Do you have a TXST ID card? *

Yes

No

Employer *

Non-Texas State University Employer

Texas State University

Are you: *

An Employee

An Intern

Are you a current Texas State student? *

Yes

No

Did you graduate from Texas State University? *

Yes

No

Check all that apply

Undergraduate

Graduate

Doctorate

Name *

New Employee Data Form

Employee Information

Emergency Contact

Access

Classification

Certification Statement