New Hire Rehire Extension
Section 1 - Position Information
Affiliation and Assignment Type:
Non Union Research Assistant
OPSEU Research Assistant
Work Study RA/Work Study Student
Post-Doctoral Fellow
Research Administrative Support
Research Professional
Research Technical Support
Position Title:
Position Number:
Department/School:
Start Date (mm/dd/yyyy):
End Date (mm/dd/yyyy):
Reports to (name and title):
Wage Rate: Yearly Hourly
Grade:
Total Salary & Benefits Cost (Assignment Cost):
Section 2 Employee Information (Always provide name and SIN# or Employee#. Complete other sections if new hire or changed information)
Employee Number:
Date of Birth: (mm/dd/yyyy)
Social Insurance Number(SIN)*:
SIN Expiry Date (mm/dd/yyyy)
(if applicable):
Work Permit
(copy attached):
Yes No
*If SIN begins with “9” a copy of a valid WORK PERMIT and SIN card MUST be attached.
Prefix:
Mr. Ms. Dr.
Last Name:
First Name:
Middle
Initial:
Sex:
F
M
Home Address (include postal code):
T4 Mailing Address if different from current (include postal code):
Email:
Phone Number:
Student:
Yes
No
Ryerson Student:
Yes
No
Undergrad
Masters
PhD
Student Number:
Section 3 Authorization
Distribution Code: Split: Effective Date:
[___][___ ___][___ ___ ___ ___ ___][___ ___ ___ ___][___ ___ ___ ___ ___ ___ ___ ___][__ __ __] $____________ %________ ___________________
[___][___ ___][___ ___ ___ ___ ___][___ ___ ___ ___][___ ___ ___ ___ ___ ___ ___ ___][__ __ __] $____________ %________ ___________________
[___][___ ___][___ ___ ___ ___ ___][___ ___ ___ ___][___ ___ ___ ___ ___ ___ ___ ___][__ __ __] $____________ %________ ___________________
I confirm that this position/appointment is consistent with applicable legislative requirements, Ryerson policies and Collective Agreements, including the
Conflict of Interest policy and Employment of Relatives policy.
Supervisor’s Signature: __________________________________________ Name:_________________________________ Date:_____________________
Co -Supervisor (if applicable): _____________________________________ Name:_________________________________ Date:_____________________
Dean/Sr. Director (if required): _____________________________________ Name:________________________________ Date:_____________________
Financial Services (if required) _____________________________________ Name:________________________________ Date:_____________________
Research Employee Contract
PLEASE PRINT CLEARLY