Affiliated Person or Emeritus Faculty Form (PER-22)
Fill out the Affiliated Person Form (pdf)
Completing the Form
Affiliation (check one):
- Affiliated Instructor: Use for those who will need to be set up as an instructor in KSIS prior to being put on the payroll as a paid employee.
- Emeritus Faculty: Use for those emeritus faculty who maintain an office on campus and want to be in the KSU Campus Phonebook.
- Other Affiliated: Use for those who need access to email, K-State Online, and other university resources.
Soc. Sec. No: Social Security Number. To be used for reporting purposes only and will not be released. If individual is a foreign national without a SSN leave
blank and indicate why under comments.
Birth Date: Employee’s date of birth. Will be used for reporting purposes only. Use MM/DD/YYYY format.
Gender: F = Female or M = Male
Emplid: An eleven digit identification number assigned to the employee when the employee is originally hired. Usually begins with a “W”. Leave this field
blank for new individuals and it will be system assigned.
Position No: Enter the 8-digit number in which person is assigned. If none available, leave blank. Human Resources will assign.
K-State eID: (electronic ID) are “electronic Ids” on K-State’s central computer systems. For information on the registration process, refer to eID’s at K-State.
Name: Enter First, Middle and Last name of person.
Home Address & Phone (Optional): Enter home address and home phone of person
Work Address & Phone: Enter work address and phone of person.
Dept ID: Enter department ID
Department Name: Enter the name of the department this person is associated with.
Job Code: Enter Job Code
Business Title: Enter business title of person.
Comments: Use this field for additional information, i.e. foreign national without SSN, or funding for foreign national is from own government/country and not