Benefits Enrollment Session Request Benefits-eligible arriving employees need to participate in the first benefits enrollment session after the date of hire. 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 sessions are generally held from 9:30 a.m. until 12:00 p.m. on designated dates, and the location is Drinko Library Room 349 unless otherwise indicated. New employees will receive confirmation 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 InformationEmployee Name First MI Last Preferred First Name Birth Date(Required) MM slash DD slash YYYY 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 SaharaYemenZambiaZimbabweÅland Islands Country Current Phone NumberEmail Position InformationEmployment Start Date(Required) MM slash DD slash YYYY Position Title(Required) Department Campus Work Location(Required)Please SelectHuntington Tri-State AirportMarshall UniversityMarshall University South CharlestonMarshall University School of MedicineMarshall University School of PharmacyMid-Ohio Valley CenterTeays Valley Regional CenterYeager International AirportSalaryAre you a 9 Month Faculty?(Required) Yes No Number of Pays (if less than 12 month employee)Session Enrollment SelectionDate of Hire Selection Date of Hire: 1/30/23, Date of Benefits Session: 1/31/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 2/13/23, Date of Benefits Session: 2/15/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 2/27/23, Date of Benefits Session: 2/28/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 3/13/23, Date of Benefits Session: 3/20/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 3/27/23, Date of Benefits Session: 3/29/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 4/10/23, Date of Benefits Session: 4/12/23 in Corbly Hall, Room 332 at 9:30 am. Date of Hire: 4/24/23, Date of Benefits Session: 4/26/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 5/8/23, Date of Benefits Session: 5/10/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 5/22/23, Date of Benefits Session: 5/24/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 06/5/23, Date of Benefits Session: 6/7/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 6/19/23, Date of Benefits Session: 6/21/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 7/3/23, Date of Benefits Session: 7/5/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 7/17/23, Date of Benefits Session: 7/19/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 8/14/23, Date of Benefits Session: 8/16/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 8/28/23, Date of Benefits Session: 8/30/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 9/11/23, Date of Benefits Session: 9/13/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 9/25/23, Date of Benefits Session: 9/27/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 10/9/23, Date of Benefits Session: 10/11/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 10/23/23, Date of Benefits Session: 10/25/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 11/6/23, Date of Benefits Session: 11/8/23 in Drinko Library, Room 138 at 9:30 am. Date of Hire: 11/22/23, Date of Benefits Session: 11/22/23 in Drinko Library, Room 138 at 9:30 am. The last hire date of the year is 12/05/2022. The first date of hire for 2023 is 01/03/2023.Comments or Special Request related to benefits enrollment should be entered belowName of Person Completing Request(Required) First Last