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Dean of the College Office
> Personnel Information Form
Welcome to Carleton!
Personnel Information Form
= required field
Please complete this form as soon as you have returned your contract letter. This information will be used by the Dean of the College office to set you up in the College computer system and will also be shared with Central Records for College mailings.
Legal last name:
Legal first name:
Legal middle name:
Current street address:
Preferred Phone Number:
Is this phone number a:
Current e-mail address:
Last four digits of Soc Sec Number:
Ethnicity - Are you Hispanic or Latino?:
Race - Regardless of your answer to the previous question, please check one or more of the following groups in which you consider yourself to be a member:
American Indian or Alaska Native
Black or African American
Native Hawaiian or Pacific Islander
If you prefer to use a first or last name different from your legal name for on-campus communication (internal campus mailing labels, event name tags, Carleton Directory, etc., i.e. Bill vs. William), please note that below:
Preferred Carleton first name:
Preferred Carleton last name:
Place of birth:
If not U.S, please indicate visa status and expiration date:
List my home address and phone on the campus web directory:
Name of Spouse/Partner:
List my spouse/partner on the campus web directory:
Phi Beta Kappa
Preferred joint mailing name (i.e., Mr. and Mrs. John Doe or Mr. John Doe, Ms. Jane Doe):
Fluency in other languages (please list):
We occasionally test students for proficiency in languages not taught at Carleton. Would you be willing to assist in language assessment? If so, which languages?
If you are a Carleton alum, what was your name as a student?
Are you a parent (past or present) of a Carleton student?
If yes, name of youngest child attending Carleton:
Emergency contact (please list name, address, phone and relationship to you):
Effective date of employment:
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This page was last updated on 8 December 2005