Personal/biographic Data Form
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Complete Personal/biographic Data Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
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2TEXASTECH PERSONAL/BIOGRAHPIC DATA FORM
Faculty
Staff
Student
R#______________________________
Full Legal Name from Social Security Card__________________________________________________________
SSN_______________________
Preferred First Name_____________________________________
Permanent Address: Street Line 1________________________________________________________________
Street Line 2____________________________________ Street Line 3_____________________________________
City_____________________________
State or Province________________ Zip or Postal Code______________
Permanent Telephone_______________________
Home Email____________________________________
Emergency Contact: Last Name____________________ First Name____________________________________
Emergency Street Line 1_________________________________________________________________________
Street Line 2_____________________________________ Street Line 3__________________________________
City_____________________________ State or Province_____________Zip or Postal Code__________________
Emergency Telephone Number_____________________ Emergency Email:_____________________________
PPAIDEN
Veteran Status and Employment Preference (State):
Check all that apply.
To claim veteran’s preference, verifying documentation must be submitted to Human Resources.
Not a Veteran
Y - Yes, Veteran
Active Duty Separation Date ___________________________
V - Veteran Preference
W - Veteran Surviving Spouse not remarried
O - Orphan of veteran killed while on active duty
U - Unknown
N - No Veteran Preference
PEAEMPL
Foster Child Preference:
To claim a foster child’s preference, verifying documentation must be submitted to Human
Resources.
I certify that I am 25 years of age or younger and was under the permanent managing
th
conservatorship of the Department of Family and Protective Services on the day preceding my 18
birthday.
EEO Reporting Data:
Choose one
Hispanic or Latino
Non-Hispanic or Latino
Race (select up to five)
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
PPAIDEN
Native Language: _______________________
GOAINTL
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Parent category: Business