First Name Last Name Preferred Pronouns Optional: Please note that your preferred pronouns will be displayed on your profile and directories. 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 keys@lpl.arizona.edu Office Phone Number UA NetID Email Please enter your netid@arizona.edu address. Your NetID may be used to create an LPL email address (i.e., NetID@lpl.arizona.edu). What employee type are you? - Select -LPL New EmployeeLPL Visitor/DCCUA Employee, Non-LPLSpace Grant InternSEDS MemberTeaching Teams Intern LPL New Employee Start Date Employee group - Select -Administrative StaffAstrobiology MinorsDCCFacultyFaculty (Adjunct)Graduate Student EmployeesNon-LPL StaffOther Graduate StudentsOther PostdocsPostdocsPTYS Graduate StudentsPTYS MinorsResearcher ScientistsRetiredSci/Eng StaffSEDSSpace Grant InternsTeaching TeamsUndergraduate EmployeesVisitorsVolunteers If you are not sure, please check with your supervisor or the HR representative. Employee Title Supervisor's Name Home Address Contact Phone Number (Home/Cell Phone) Print home/cell phone number in LPL online directory? - Select -YesNo Current email address (personal or non-LPL) Preferred 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. Go to the UAccess page. Select Edge Learning. Log in with your UA NetID. In the search bar type in "Conflict of Interest Required Disclosure Training". Space Grant Intern/SEDS Member/Teaching Teams Intern Start Date Employee Title Supervisor's Name Home Address Contact Number (Home/Cell Phone) Current/personal/non-LPL email address LPL Visitor/DCC Your Current/personal/non-LPL email address An LPL email address will not be created for visitors with a stay of 4 weeks or less (UA email and/or personal email address will be used). If you are visiting for 4 weeks or less and require an lpl email address, please indicate here. No - I am visiting for 4 weeks or less, but do not need an lpl email address Yes - I am visiting for 4 weeks or less and do need an lpl email address Visit Start Date Visit End Date Title - Select -Visiting ScientistVisiting Research AssistantVisiting StudentVisiting Scholar Country of Citizenship Dual Citizenship? No If Yes, Country Enter other… U.S. Green Card Holder No Yes Visa Classification Reason for Visit (describe in detail) Name of Faculty Sponsor Will the visitor be collaborating on sponsored research projects No Yes Which projects? (Include FRS #'s) Notice *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 - Select -FIB-SEM UserTEM UserOther... Enter 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. - Select -YesNo LPL New Employee Resources (PDF) | Procurement Guidelines (PDF) | Traveling Guidelines (PDF) | LPL FAQ Complete the BeeBole Timesheet Training at the URL below in order to complete and submit this training. BeeBole Timesheet Training Complete the UA Security Awareness Training using the link below in order to complete and submit this form. All-employee 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. Complete the Emergency Contact Information form at the URL below in order to complete and submit this form. Emergency Contact Information Form Complete the Whistleblower Awareness Training using the link below. Whistleblower Awareness Training To complete this training, you must be entered into the UA system. Note: If you cannot access this training, please try again. Submit Leave this field blank
