2025 New Employee Registration Form

DATE OF NEO*
NEO TIME*
Please select one
EMPLOYEE NAME*

First NameLast Name
Employee ID #
Employee Action*

New HireRe-HirePromotionPT to FTDepartmental Change/Transfer
Work Phone

Area CodePhone Number
Employee Email *
You MUST provide a personal or work email to submit this form
Date of hire / rehire
Employees Job Title *
Employees work schedule (EX: 8:30am-5pm)*
This is required per AB 119 for union reporting information
Employees work location / assignment location*
This is required per AB 119 for union reporting information
Employee Department*
Please select one
Employee Status Select One *
ELDE Term Start Date

MonthDayYear
Date
ELDE Term End Date

MonthDayYear
Date
Employee Job Class *
This is required per AB 119 for union reporting information
Employee Rep Unit *
This is required per AB 119 for union reporting information (EX: TW1, SD1, UM2...)
Union*
This is required per AB 119 for union reporting information
Supervisor Name *
The person that approves employee's time card
Supervisor Email
example@example.com
Supervisor Phone
Please use city phone number
Is this employee classified as a supervisor?*

YesNo
Is this employee a FORM 700 Filer?*

YesNo
Is this employee Benefit eligible?*

YesNo
Does this employee need to attend Benefits 101 before NEO?

YESNO
Name of HR SPOC / Admin / Payroll Staff completing this form

First NameLast Name
Email of HR SPOC / Admin / Payroll Staff completing this form
example@example.com
Any other requests, details HRM should know when processing this form?
Should be Empty: