HomeHuman ResourcesEmploymentEmployee Data Collection Form Welcome to University of Maryland – College Park EMPLOYEE DATA COLLECTION FORM Step 1 of 2 50% Welcome to the University of MarylandWhat Department will you be joining?* Mechanical Engineering Are you a current of returning employee?* Yes No NOTE: If you are supplying data for your very first payroll appointment at UMD, you are NOT a current/returning employee.UMD Appointment Status* Active (I currently have a job on campus) Inactive (I had a PREVIOUS position on campus which ended) Will you be employeed as a Teaching Fellow?* Yes No Did you have a previous Teaching Fellow appointment?*Yes. In Aerospace Engineering.Yes. In Fire Protection Engineering.Yes. In Mechanical Engineering.Yes. In another department.No. This is my first year as a TF.Personal DataName* First Middle Last Suffix Date of Birth* MM slash DD slash YYYY Gender* Female Male Hispanic or Latino origin?* Yes No Racial Identity (optional) White Black or African American Asian American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Do you have a University of Maryland ID Number?* Yes No University of Maryland ID Number* Do you have a Social Security Number?* Yes No Social Security Number* Numbers Only – Do NOT include dashesEmail* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Country PhoneAre you 18 or older?* Yes No Visit Maryland.gov for Minor Work Permit InformationI certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States.* Yes No Work Authorization Category U.S. Citizen Permanent Resident (I-551 Card) Permanent Pending (awaiting issue of Permanent Residency) Authorized Foreign National (I-94 & Foreign Passport) Authorized Foreign National (I-766 – EAD Card) You will need to present your government issued ID to HR at your On-boarding Meeting. Are you a foreign national in the U.S. on a VISA* Yes No (If you are on a J, F or H Visa you must answer “yes,” and submit Visa information) Education (If no higher ed, please write N/A)(Please list ALL Higher Education Degrees)Institution Name* Location of Institution* Degree Type* Discipline* Date Degree Earned* MM slash DD slash YYYY Add another degree?* Yes No Additional degrees*Please list all additional degrees, including year, degree type, and institution.