H.R. Services Benefit Enrollment Session Request Form

FULL SEARCH


	MU Home

BENEFITS ENROLLMENT WORKSHOP REQUEST

Benefits-eligible arriving employees need to participate in a benefits enrollment workshop close to their beginning date of employment. Sessions are designed to provide arriving employees with information about their benefits and to assist them in completing the necessary forms to enroll in benefit components. These workshops are generally held from 9:30 a.m. until 12:00 p.m. on designated dates, and the location is the Human Resource Services Conference Room in 207 Old Main unless otherwise indicated. New employees will receive confirmations with their Benefits Packages.

Use this form to request a reservation for a benefits enrollment session for your newly hired employee. Simply fill in the fields below and/or make selections where dropdown lists are provided. When you are sure the information you have entered is correct, hit the Submit button.

If you experience any difficulty with this web form, you can accomplish your registration by contacting Human Resource Services either by telephone or by e-mail. Thank you!

Employee name: Birth Date:

Current telephone number with area code:

Current e-mail address:

Current mailing address:
City State Zip

Employee will be employed by the following institution:

Department/college or office:

Position title (faculty, Program Assistant, etc): Annual Salary:

9-month faculty: If Tenure Track, 18 or 24 pays:

Employment will begin:
Month Day Year

Campus work location:

I wish to participate in the benefits enrollment workshop scheduled for (should be the date closest to but following the date you started to work or will start to work):

Employee's workstation is not/will not be in Huntington. For this reason he/she requests to participate in benefits enrollment via telephone and web browser from a distant location:

They have been advised that participation in benefits enrollment from a distant location will require a simultaneous telephone connection and internet connection for the web browser. They understand (1) that they will be called by the benefits enrollment facilitator at no toll charge to them; (2) the computer they use must be equipped with a web browser; and (3) any expense associated with the web connection for the web browser is their responsibility.

Location and telephone number for benefits enrollment at a distance will be:

Comments or special requests related to benefits enrollment should be entered below:

GO TO THE HUMAN RESOURCE SERVICES HOME PAGE

This page edited by Jim Stephens, 304.696.3983, jstephen@marshall.edu


	Site Maintained by Human Resource Services. Copyright © 2008 Marshall University. All Rights Reserved. Read Site Disclaimer and Privacy Policy for more information. Marshall University - One John Marshall Drive - Huntington, WV 25755