INDIVIDUAL SSN
(Key)
- Enter the instructor’s SSN.
USER AGENCY
(Required)
-
Enter your agency number.
-
Note: This field is required when you insert a record. The agency number is suppressed once the record is processed.
NAME – FIRST, MIDDLE, LAST
(Required)
-
Enter the instructor’s full name (middle name is optional). Do not use punctuation marks (hyphens are acceptable).
-
Note: If the name has a suffix, put it in the LAST NAME
field preceded by a space. For example, John C Smith Jr or William E Harris III (no periods, commas, or special characters).
FAMILIAR NAME
(Optional)
- The name by which the individual wishes to be known.
ADDRESS LINE 1
(Required)
- The instructor’s home or mailing address.
ADDRESS LINE 2
(Optional)
- Any additional street address or P.O. box information.
CITY
(Required)
STATE
(Required)
ZIP CODE
(Required)
COUNTY
(Required)
-
Press F2 twice for values (Decode Table 872).
-
Note: If you leave this field blank and the individual resides in the USA, the system will display the correct code for this field after you process the transaction.
SEX
(Required)
-
RACE
(Required)
-
0 |
White |
1 |
Black |
2 |
Hispanic |
3 |
Asian |
4 |
American Indian or Alaskan Native (AIOAN) |
5 |
Other (Higher Education Agency Use Only) |
6 |
Native Hawaiian or Other Pacific Islander (NHOPI) |
7 |
Two or more races (MULTI) |
BIRTH DATE
(Required)
- Enter the employee’s birth date. This information is required for insurance purposes.
EDUCATIONAL LEVEL
(Optional)
- Displays individual’s level of education.
Blank field |
Not defined |
A |
Doctorate |
B |
Post doctorate |
C |
Bachelor's – vocational rehab |
D |
Master’s – vocational rehab |
E |
Bachelor’s – social work |
F |
Master’s – social work |
G |
Doctorate – social work |
0 |
Less than high school |
1 |
High school or equivalent |
2 |
Some college |
3 |
Two-year college degree |
4 |
Four-year degree (unrelated to business) |
5 |
Four-year degree (related to business) |
6 |
Some post graduate work |
7 |
Post graduate degree (unrelated to business) |
8 |
Post graduate degree (related to business) |
9 |
Master’s |
Note: Individual information such as sex and ethnicity is not included on required reports to other government entities unless the instructor is an employee. The system considers the instructor an employee if he or she has been assigned to a position on HMPNH.
RELEASE DATA SECTION
-
Enter a value indicating whether the individual allows the agency to release any of the following information to the public. A value of Y (yes) or N (no) will be used to determine whether the employee's address, home phone, Social Security number, family information and emergency contact can be released under the Open Records Act.
- Address (Required)
- Home Phone (Required)
- SSN (Required)
- Family Info (Required)
- Emer Contact (Required)