New/Update Employee Request

First Name *
Middle Name
Last Name *
Credentials (if applicable) Example: MD, NMS, PhD, MSW, Etc.
Position and Title *
Second Position and Title (if applicable)
Third Position and Title (if applicable)
CCHS Department or UMC Clinic *Example: Communications, Sports Medicine, Health IT, UMC Northport
Building *
Office Phone Number *
Email *
MyBama Username *
Do you have a bio? *
YesNo
Bio *
Please paste your bio (no more than 200 words) Must be between 75 and 200 words. Total words: 0

Biography Section for Online Directory

What is your primary job title and department at CCHS? *
Example: Leslie Zganjar is the Director of Communications and Community Relations for the College of Community Health Sciences. Maximum words allowed: 50. Total words: 0
List your job functions and responsibilities *
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. Must be between 5 and 100 words. Total words: 0
Outline your education including degrees and certifications
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.Not required, but if you have degrees and certifications please enter them here. Must be between 5 and 100 words. Total words: 13
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.Not required, but if you have professional achievements or career-related honors please enter them here. Maximum words allowed: 100. Total words: 15
List any professional memberships.
Not required, but if you have professional memberships please enter them here.Maximum words allowed: 100. Total words: 12
Have you had your photo taken by UA Photography? *
YesNo
You are required to have a photo taken by UA Photography. Go to Rose Administration basement room number G5. Photos are shot the first Monday and second Tuesday of every month from 8am-5pm. More information about headshots

Verification

Please enter any two digitsExample: 12
This box is for spam protection - please leave it blank