Samford University
Human Resources
Staff New Hire Form
New hire’s name: ________________________________________ Social Security #: _______________________
(Print)
Date to report to work: __________________ Title: ____________________________________________________
School/Dept.: ____________________________ New hire reports to: ____________________________________
Campus address: _______________________ Campus phone #: _____________ Campus fax #: _____________
(bldg. & room #)
_____ Full time _____ Part time
_____ Full time, less than 12 months and dates of assignment: _______________ to ________________
_____ Temporary assignment; Dates of assignment from _______________ to ________________
Hours per week _________ Days per week _________
Rate of Pay: ______________ or ______________ Salary Grade: _______
(hourly) (monthly)
This new hire is replacing: ______________________________________
Position Control #: ___________________________
FOAPAL:
Index: ____________ Fund: ____________ Org: _____________ Acct: _____________ Prog: _____________ % _____
Index: ____________ Fund: ____________ Org: _____________ Acct: _____________ Prog: _____________ % _____
Index: ____________ Fund: ____________ Org: _____________ Acct: _____________ Prog: _____________ % _____
Signatures as applicable:
Dept Head: __________________________________________ Date: _______________________
Dean: ______________________________________________ Date: _______________________
Vice Pres. or Provost: ___________________________________ Date: _______________________
Position Control: _______________________________________ Date: _______________________
Budget: _____________________________________________ Date: _______________________
Human Resources: _____________________________________ Date: _______________________
Rev 9/09