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Information About You and Your Appointment
Appointment Type
Faculty Full-time
Faculty Part-time
Faculty Summer Only
Staff
Contracted/Non-Miami Employee
Intermittent/Consultant
Other
Enter the name of the contractor/company you work for
If Other, please comment
Are you tenure-track or do you have an appointment with tenure?
Are you tenure-track or do you have an appointment with tenure?
Yes
No
For tenure-track or appointment with tenure, please note your research interests here
Name (as it appears on your Social Security Card or your full legal name)
Home Street Address Line 1
Home Street Address Line 2
City
State, Province, or Territory
Country/Nation
Are you a U.S. citizen?
Are you a U.S. citizen?
Yes
No
Citizenship, if not U.S citizen
Visa Status
F1/OPT
CPT
H1
IM (Immigrant)
J1
O1
PR (Permanent Resident)
RA (Resident Alien)
TN
EAD
Asylum status
Pending
Visa Expiration
(mm/dd/yyyy)
Date of Birth
(mm/dd/yyyy)
Do you have a social security number?
Do you have a social security number?
Yes
No
Social Security Number
Gender
Male
Female
Marital Status
Single
Married
Divorced
Widowed
Separated
Name of Spouse or Partner
Hiring Department or Program
Hiring Campus or Learning Center
Are you currently receiving retirement benefits from the State of Ohio?
Are you currently receiving retirement benefits from the State of Ohio?
Yes
No
Race/Ethnicity - Required for Federal reporting purposes
Are you Hispanic?
Are you Hispanic?
Yes
No
If Hispanic, select your Hispanic origins
If Hispanic, select your Hispanic origins
Mexico
Puerto Rico
Other
If non-Hispanic, check all that apply
If non-Hispanic, check all that apply
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Emergency Contact (At least one emergency contact is required)
Contact Name
Relationship with Contact
Contact's Address
Contact's Phone Number
Do you want to add a second emergency contact?
Do you want to add a second emergency contact?
Yes
No
Second Contact's Name
Relationship with Second Contact
Second Contact's Address
Second Contact's Phone Number
Education and Professional Experience
Have you already submitted a cv or resume as part of an application packet?
Have you already submitted a cv or resume as part of an application packet?
Yes
No
Education - include College or University, City/State, Degree Type, and Date Earned or Number of Years Attended
Professional Experience - Include the Employer, Position/Rank/Title, Start Date, and End Date
Other Fields
Your name
Your first name
Your last name
Your email address
Your phone number
Verification Code