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Office of the Provost
Incoming Faculty
Personnel Information Form
Personnel Information Form
Please complete this form as soon as you have returned your contract letter. This information will be used by the Dean of the College office to set you up in the College computer system and will also be shared with Central Records for College mailings.
Legal last name:
*
Legal first name:
*
Legal middle name:
Current street address:
*
City:
*
State:
*
Zip
*
Preferred Phone Number:
*
Is this phone number a:
*
Cell Phone
Land Line
Other
Current e-mail address:
*
Last four digits of Soc Sec Number:
*
Gender:
*
Male
Female
Birthdate:
*
Ethnicity – Are you Hispanic or Latino?:
Yes
No
Race – Regardless of your answer to the previous question, please check one or more of the following groups in which you consider yourself to be a member:
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
If you prefer to use a first or last name different from your legal name for on-campus communication (internal campus mailing labels, event name tags, Carleton Directory, etc., i.e. Bill vs. William), please note that below:
Preferred Carleton first name:
Preferred Carleton last name:
Place of birth:
Are you a US citizen:
*
Yes
No
If non-US citizen, please list country of citizenship and current Visa status and expiration date:
Name of Spouse/Partner:
Member of:
Phi Beta Kappa
Sigma Xi
Preferred joint mailing name (i.e., Mr. and Mrs. John Doe or Mr. John Doe, Ms. Jane Doe):
Native language:
Fluency in other languages (please list):
We occasionally test students for proficiency in languages not taught at Carleton. Would you be willing to assist in language assessment? If so, which languages?
If you are a Carleton alum, what was your name as a student?
Are you a parent (past or present) of a Carleton student?
Yes
No
If yes, name of youngest child attending Carleton:
Emergency contact (please list name, address, phone and relationship to you):
Department:
*
Position:
*
Effective date of employment:
*
Comments
This field is for validation purposes and should be left unchanged.
Comments
This field is for validation purposes and should be left unchanged.