Pre-hire/Affiliate UCSBNetID Request

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To request a new UCSBNetID or extension for a pre-hire or an academic affiliate, please fill out this form. Requests should be made by HASC Academic Personnel staff or must have Department Chair/HASC Director approval.

*Note: Email will no longer function once affiliation has been terminated.*

Requestor's Email Address *

Type of Request

New

Extension

Clear selection

Affiliate's First Name *

Affiliate's Middle Initial

Affiliate's Last Name *

Affiliate's Email Address (if different from requestor)

Affiliate's Birthday *

YYYY

Last four digits of SSN (required for Pre-hire)

Department *

Affiliate Type *

The "academic-affiliate" is assigned to visitors having academic business with the University but do not fit the criteria of a formal University title. This affiliation was formerly known as "visiting scholar". The "pre-hire" affiliation is assigned to new hires -- typically faculty -- that require a UCSBnetID for access to network resources prior to being added to the payroll system.

Affiliate Separation Date *

Max Length, 1 year for Affiliates, 6 months for Pre-Hire

YYYY

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