Please complete the below listed information for each employee earning a 25-year award. This information must be submitted to the Faculty/Staff Newswire by a human resources representative. (This includes human resources representatives, human resources officers and directors of business services.)
Employee's first name
Employee's middle name (optional)
Employee's last name
Employee's title
Work unit
25-year anniversary date: Choose month January February March April May June July August September October November December 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
HR representative:
Please select one:
The 25-year award recipient has been given the name and contact information for the area (college, campus, department, etc.) photographer. The area photographer will submit the photograph to Melissa Rugh at mrh26@psu.edu.
A professional-quality photo of the 25-year award recipient will be e-mailed to Melissa Rugh at mrh26@psu.edu.
The 25-year award recipient is not interested in having his/her photo appear in the Faculty/Staff Newswire's 25-year award section. Please simply list the employee's name, title and unit in this section.
The 25-year award recipient is not interested in having any information regarding their 25-year award published.
Please provide your name, e-mail address and phone number so that we may contact you if we need additional information:
Name:
E-mail address:
Phone number: Area Code: Number:
If you have any questions, please call Melissa Rugh at (814) 865-7517 or e-mail mrh26@psu.edu.
Please complete all fields before you submit this form.