Adjunct Instructors: Please fill out the following form. All fields are mandatory. Once completed, have your Department Chair or Department Assistant to the Chair sign the lower portion and fax it to 973-596-2905, drop it off,  or interoffice mail the form to the Computing Helpdesk. Your information will be added to the database within 24 business hours at the longest as long as all field are completed and signed.

After 24 business hours, please go to http://newaccount.njit.edu to self-create your NJIT UCID.

PLEASE PRINT ALL INFO: 
 

Full Name: (First, Middle Initial, Last)	_________________________________________________
Social Security #:	_________________________________________________
NJIT Department:	_________________________________________________
Date of Birth: (month, day, year)	_________________________________________________
Home Zip Code :	_________________________________________________
Contract Expiration Date: (if no date is entered, account will expire at end of current semester)	_________________________________________________
Class and Section: (ex. CIS101-999)	_________________________________________________
Current email address:	_________________________________________________

I hereby acknowledge that the above individual is currently a faculty member in our department and that the above information is correct.

Signature of Department Chair or Asst Chair ___________________________________________	Phone # ________________	Date _______________
Printed Name of Department Chair or Asst Chair ___________________________________________