Information below must match legal documentation (i.e. I-9 or Social Security Card).
Middle Name (Enter N/A if not applicable)
Date of Birth
Email (where University ID will be sent)
Date of Hire
Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Year 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Have you ever applied to GW as a student?
Have you been affiliated with GW before? (Student, Faculty, Staff, Affiliate)
GWID (If known)
Are you currently a GW student?
Other name you may have had while previously affiliated with GW (i.e. Maiden Name)
Employment Eligibility Status
Colleges and universities are asked by many, including the federal government, accrediting associations, college guides, and our own college/university communities, to describe the ethnic/racial backgrounds of their students and employees. In order to respond to these requests, we ask you to answer questions 1 and 2 as applicable:
Ethnicity 1. Do you consider yourself to be Hispanic or Latino? (Persons of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race)
Race 2. In addition, you may select one or more of the following racial categories to describe yourself:
If both Vietnam/other eligible veteran, Date of Separation:
*If other disability status, please list (Need a reasonable accommodation? Contact the EEO Department to make your request.)
Are any relatives or members of your household currently employed with The George Washington University?
Relationship to you
Relationship to you 2
CAMPUS ADDRESS / EMERGENCY CONTACT INFORMATION
Campus (Primary Office Address, if known):
Name of Your Department
Home Zip Code
Home Email Address
Emergency Contact Information:
Emergency Contact Name
Emergency Contact Relationship to You
Emergency Contact Address
Emergency Contact City
Emergency Contact State
Emergency Contact Zip
Emergency Contact Phone Number
Please report any changes to the information listed above to Human Resource Management and Development.
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