College HR Requests For UFID/Gator1 bulk requests, please send excel spreadsheet with this information via email to Jennifer Horn. Please reference Identity Registry Affiliations for the type of affiliation you need. Request to Fill FormPosition Description TemplateCourtesy Faculty Process – – Courtesy Faculty Checklist Requesting:(Required) Affiliation Courtesy Faculty Appointment Gator1 Card Request to Fill Position UFID # Name(Required) Email(Required) Requesting Department/Department ID(Required) Additional InformationAffiliationType of Affiliation(Required) (i.e. Departmental Associate, Volunteer, Vendor, Future Staff/Faculty, etc.)Expiration Date of Affiliation: MM slash DD slash YYYY Note: Expiration will be 90 days from submission if no expiration date is providedUFID (if no UFID, please check to request UFID above): UFID #Legal Name(Required) Maiden Name, if applicable Date of Birth(Required) MM slash DD slash YYYY *Verification of SSN may also be requiredPhone(Required)Mailing Address(Required) Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Gator1 CardUFID (if no UFID, please check to request UFID above): Name(Required) Title(Required) Photo(Required)Accepted file types: jpg, Max. file size: 125 MB.Must be close-up/cropped, have good lighting, be clear, have a solid background. Please avoid: sunglasses, bad lighting, far away images, hats (Hijabs are allowed, veils are not), inappropriate facial expressions.Courtesy FacultyPlease review the Courtesy Faculty Process and the Courtesy Faculty Checklist prior to submitting a request. Also note: the dean must approve the courtesy appointment and sign the offer letter before any offer is given. In addition, a health assessment must be completed before any clinical privileges can be given.Department Admin(Required) Name of Potential Faculty(Required) Faculty Email(Required) Courtesy Title(Required) (Clinical Assistant/Associate Professor, Research Assistant Professor, etc.)Duties(Required) (i.e. providing clinical teaching in the pre‐doctoral oral surgery clinic)Expected Start Date(Required) MM slash DD slash YYYY UFID (if no UFID, please check to request UFID above): Required Documents(Required) Drop files here or Select files Max. file size: 125 MB. CV and Emergency Contact Form. See Courtesy Faculty Checklist for other required documents. Please also upload the following if you already have copies: CPR/BLS or ACLS card, copy of FL dental license, copy of DEA (if applicable), and board certification (if applicable). Please ensure not to include the SSN - this is not a requirement for Courtesy Appointments.Request to Fill PositionAdditional hiring authority/admin to receive copy of this request: Please enter email address onlyPosition Title(Required) New/Replacement New Replacement Name of person being replaced:(Required) Request to Fill Form(Required)Max. file size: 125 MB.All signatures of approval are required prior to review. Please attach any documentation that may be necessary for consideration, such as position descriptions, additional justification for the request, etc.