INSTRUCTIONS:
Place an * by any updated information or a correction.
| Last Name First Name | |
| Department | |
| Position/Title | |
| Faculty __________ Staff ________ Department Head ________ | |
| Building | |
| Room Number | |
| Office Phone Number | |
| Home Street Address | |
| City State Zip | |
| Home Phone Number | |
| E-Mail Address |
Is the above information: __ Addition of a New Employee
__ A Correction of an Existing Employee's Information
__ A Deletion of an Employee
Please send completed forms: Via campus mail to Toni Napier, Telecommunications Specialist or by fax to 2101, Attn.: Toni Napier