<%option explicit%> <%response.buffer=true%> Student Request for Approval to take an ECC On-Line Course

Edgecombe Community College
New Employee Notification Form
(Will add employee to the ECC employee web directory)
(Will request creation of various IT accounts)

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Employee Data

(Required Fields Marked by an Asterisk)


        Starting Date (mm/dd/yy) *.............

        First Name *................................

        Last Name *................................

        Job Title *...................................

        SSN (last 4 digits only) *..................
                                                          
        Work Phone (include area code) *..... (enter digits only)
        
        Extension*...................................... (enter 000 if no extension)

        Campus*.........................................

        Building*.......................................

        Office number*.................................  

Please check the employee status:

Full Time
Part Time

Please check the employee category:

Faculty
Staff
Administration

Please check the systems the user needs to access:

Groupwise
IIPS Unix
Colleague Unix
BlackBoard (check only if faculty)


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