Administration
Human Resources
  Contact Us
 Employee News


Back to Main Forms Page

 

Forms > Employee Data Form

Some of the information requested below is provided to the University System of Maryland and other State and Federal agencies as required by law. Data supplied to the USM offices is of a statistical nature only, with no direct reference to you. Please complete this form in full, and submit when complete.

Fields marked by * are required.

* First Name:
* Middle Initial
* Last Name:
* Title (prefix):
* Date of Birth: (MM/DD/YYYY)
* Address (Number and Street):
* City:
* State:
* Zip:
* County of Residence:
* Home Telephone:
* Email Address:
* Gender:
* Marital Status:
* Race:
* Military Status:
* Highest Level of Formal Education Achieved:
First Degree Code
First Degree Type (i.e. Bachelor's, Master's, Doctor's)
First Degree Date
First Granting Institution
Second Degree Code
Second Degree Type
Second Degree Date
Second Granting Institution

Visa Status (if Non-US Citizen)
Visa Code:

Emergency Contact Information

* First Name:
* Last Name:
* Telephone:

 

 

  
 
Web Page Manager: bclark@frostburg.edu    Copyright  |  Privacy
Frostburg State University, 101 Braddock Road, Frostburg, MD 21532-2303.