Department of Human Resources

Orientation/Benefits Packet Request Form for non-academic employees with 75% - 100% appointments

Note: This form must be filled out by all hiring departments (or department's payroll representative) for employees who:

• are a new hire with 75-100% appointment
• transferred up to 75-100 percent time appointment (example, transfer from temp and casual, on-call appointment or under 74% appointment)
• if temporary, appointment is three months or longer

For more information about Orientation procedure, see http://www.d.umn.edu/umdhr/Policies/hiring/09.htm

*Name of employee
*Empl ID (or type 00 if you don't have Empl ID )
*Department name
*Campus Address
*Employee's Campus Telephone #, if known. If not known, type N/A
*Job Requisition Number
*Job Code
*Percentage of Appointment
*Start Date
If Temp Appt, fill out End Date
*Supervisor's Name
*Supervisor's Telephone number
*What is Your Name?
*What is Your Campus Phone #?
*What is Your Complete Email Address?

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