EMPLOYEE DATA FORM
(ALL DATA MUST BE COMPLETED FOR PAYROLL PROCESSING)
*Last Name: First Name: MI: Known By:
Address: City:
State: Zip: Phone: Male Female
Title: Mr. Mrs. Miss Ms. Dr. Rev. Sr. Suffix: DDS PhD MD SJ Jr.
Social Security Number: Date of Birth: Status: Single Married
Department: Hire Date:
Registered Disabled: Yes No Religion: Baptist Cleric Religion: Not Applicable
Buddhist Jesuit
Catholic Non-Jesuit Catholic Clergy
Veteran Status: Not a Veteran Eastern Orthodox Other Non-Catholic Clergy
Disabled Veteran Episcopal/Anglican Women Religious
Disabled Vietnam Veteran Evangelical
Vietnam Veteran Hindu
Other Eligible Veteran Jewish
Other Eligible Disabled Veteran Lutheran
Methodist
Separation Date:
Ethnic Origin: Are you Hispanic or Latino?
Yes, I am Hispanic or Latino
No, I am not Hispanic or Latino
Muslim
Other Christian
Other Non-Christian
Presbyterian
UCC
Not Applicabl
No matter what you selected above, please continue to answer the following
question. What is your Race? (Select one or more)
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Highest Degree Obtained: High School GED/HED Associate Bachelor Master PhD
Date Received: Institution Name:
DDS MD JD
DPT
Emergency Contact Name: Contact Address:
Contact Phone Number: Relation to Employee:
Send completed form to Human Resources IMMEDIATELY (Before Date of Hire) by email, fax or regular mail
Marquette University, Department of Human Resources, Straz Tower Rm. 185
P.O. Box 1881
Milwaukee, WI 53201-1881
(414)288-7305 Fax: (414)288-7425
Email: humanresources@marquette.edu
HR 11/11
* If you have previously
been issued an MUID
and your name has
changed, you must
submit a Name Change
Request Form,
available from the MU
Central web site. A
Marquette University
Identification Number
(MUID) is issued to
students, student
applicants, parents,
and employees *
