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 Department of Human Resources & Equal Opportunity

Workers' Comp

Orientation Request for Employees

(Note: required for eligible non-academic employees and fill out if an academic employee would like an orientation)

Hiring department (supervisor or payroll representative) must fill out the form for their employee/s if they:

  • are new hire with 75-100% appointment
  • have transferred up to 75-100 percent time appointment (example, transfer from temp and casual, on-call appointment or under 74% appointment)
  • are hired on 75-100% temporary appointment lasting three months or longer; and
  • has an appointment of 50-74% lasting three months or longer.

Hiring department does not need to fill out this form if it is a transfer from one department to another with employee already on 75% or more appointment from previous department and there is no break in service.

Choose one:
New hire
Transferred to 75-100 % appointment
Temporary appointment of 75-100% lasting three months or more
50-74% appointment lastting three months or longer

*Name of Employee
*Empl ID (or type 00 if no Empl ID available)
*Employee's Department
Employee's Campus Address
Employee's Campus Telephone #, if known
Employee's Work Hours, if known
*Job Requisition Number
*Job Code
*Percentage of Appointment
*Start Date
If Temp Appt, fill out End Date

*Supervisor's Name
*Supervisor's Campus Phone #

*What is Your Name?
*What is Your Campus Phone #?
*What is Your Complete Email Address?


Reset form will delete all your entries

The E-mail address listed will automatically receive a copy of this form.

Note for academic employees: The Office of the Exectuvie Vice Chancellor for Academic Affairs sends out the Guide for UPlan Benefits Enrollment to academic employees upon receipt of the (PAD) Personnel Action Document. The Guide is also available online.


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The University of Minnesota is an equal opportunity educator and employer.
Last modified on 03/17/14 08:15 AM
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