LPL Information/New Employee Form

First Name *

Last Name *

LPL Building, Office and/or Lab Space Assigned *

If you require access to additional rooms (labs, additional office space, etc.) your supervisor must email a list of required rooms to

Office Phone Number

What employee type are you? *

LPL New Employee

Start Date *

Month

Day

Year

Employee group *

If you are not sure, please check with your supervisor or the HR representative, Tara Bode.

Employee Title *

Supervisor's Name *

Home Address *

Contact Number *

(Home/Cell Phone)

Print home/cell phone number in LPL online directory? *

Current/personal/non-LPL email address *

Suggested LPL email user name (no more than 8 characters) or assigned LPL email address, if known (for LPL faculty, staff, and LPL graduate students) *

Kuiper employees use @lpl.arizona.edu | Drake employees use @orex.lpl.arizona.edu | Sonett employees use @pirl.lpl.arizona.edu

Complete the Conflict of Interest Disclosure Training using the link below in order to complete and submit this form. *

I have completed the Conflict of Interest Disclosure Training.

Conflict of Interest Disclosure Training (See instructions for the disclosure system.)

Space Grant Intern/SEDS Member

Start Date *

Month

Day

Year

Employee Title *

Supervisor's Name *

Home Address *

Contact Number *

(Home/Cell Phone)

Current/personal/non-LPL email address *

LPL Visitor

Your Current/personal/non-LPL email address *

UA NetID (if known) *

UA NetID will be used to create a LPL email address. If you don't know your NetId OR it is more than 8 characters, please enter a suggested LPL email user name that is no more than 8 characters.

Visit Start Date *

Month

Day

Year

Visit End Date *

Month

Day

Year

Title *

Country of Citizenship *

Dual Citizenship? *

If Yes, Country

Dual Citizenship? If Yes, Country

U.S. Green Card Holder *

Yes

Visa Classification *

Reason for Visit *

(describe in detail)

Will the visitor be collaborating on sponsored research projects *

Yes

Which projects? *

(Include FRS #'s)

*Department Export Control Administrator (Glinda Davidson) approval is required prior to allowing a visitor to participate or have access to a sponsored project that is not identifed above.

Name of LPL employee you report to *

UA Employee, Non-LPL

Title Group *

Title Group Other...

Title *

Home Department *

Name of LPL employee you work with *

Have you reviewed the LPL resources and guidelines documents listed here? If "no," please do so ASAP. *

LPL New Employee Resources | Procurement Guidelines | Traveling Guidelines | LPL FAQ

Upload your Harassment Prevention Education completion document here in order to complete and submit this form. You can complete the training using the link below. *

Harassment Prevention Education
Files must be less than 2 MB.
Allowed file types: jpg jpeg png psd pdf doc docx.

Complete the UA Security Awareness Training using the link below in order to complete and submit this form. *

I have completed the UA Security Awareness Training.

To complete this training, you must be entered into the UA system. Note: If you cannot access this training, please try again. All-employee Security Awareness Training

Complete the Emergency Contact Information form at the URL below in order to complete and submit this form. *

I have completed the LPL Emergency Contact Information form.

Emergency Contact Information Form

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LPL Information/New Employee Form