New/Update Employee Request

Name(Required)

First Middle Last

Credentials (if applicable)

Example: MD, NMS, PhD, MSW, Etc.

Position and Title(Required)

Second Position and Title

Third Position and Title

CCHS Department or UMC Clinic(Required)

Example: Sports Medicine, Health IT, UMC Northport, External Relations

Building(Required)

Office Phone Number(Required)

Email(Required)

MyBama Username(Required)

Do you need a bio on one of our pages? (Faculty Member, Resident, DEI Committee, etc.)(Required)

Yes

Do you have a bio?(Required)

Yes

Bio(Required)

Please paste your bio (no more than 200 words)

What is your primary job title and department at CCHS?(Required)

Example: Leslie Zganjar is the Director of Communications and Community Relations for the College of Community Health Sciences.

List your job functions and responsibilities(Required)

Example: Leslie is responsible for operational communications for the College and works to promote the College and its mission, programs and efforts both internally and externally. She oversees media and public relations, advancement and alumni affairs, websites and social media and marketing.

Outline your education including degrees and certifications *(Required)

Example: Leslie received a bachelor’s degree in Journalism from Louisiana State University and a master’s degree in Public Administration/Public Policy from The University of Alabama. She is a certified grant writer.

List any professional achievements or career-related honors

Example: Leslie spent more than a dozen years as a reporter and editor for The Associated Press in New York and Louisiana, where she was recognized for one of the 15 best feature stories in the Associated Press.

List any professional memberships

Have you had your photo taken by UA Photography?(Required)

Yes

Photo Acknowledgement(Required)

I understand that I am required to have a photo taken by UA Photography. I will go to the Rose Administration basement and have a photo taken. Photos are shot the first Monday and second Tuesday of every month from 8am-5pm.

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