New Employee Form

MPLP New Staff Information Form

Name:________________________________________________________
Position:______________________________________________________
Program:______________________________________________________
Office:_______________________________________________________

Do you need a MLAN email account? Yes or No

If No, what is your email address:____________________________

Areas of Concentration (if any):___________________________________

Date Hired:____________________________________________________

Person Submitting Information:____________________________________

Date:_____________________

Please fax or email this to Adrianna Buonarroti at MPLP. Fax number (734) 998-9125.

For MPLP use: ___MLAN.net account ___address database ___Desk Reference ___new employee packet
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