New or Change Information Needed by the Central Office

The information you provide will be added to the Department's Website (roster, etc.). If we already have your information submitting this form will activate a revision to that information.

If you have any questions filling out this form, please contact the Central Office
625-2818 or email psymain@umn.edu

Last Name:
First Name:
E-mail Address:
 
Status
Primary Area
If Staff, title:
If your location is on campus:
Building Name:
Office Room #:
Office Phone:
 -
Lab Room #:
Lab Phone:
 -
If your location is off campus:
Facility Name:
Address:
City:
State:
Zip:
Phone:
* The following information will be used by the Chair's Office
in emergency situations only
*Home Address:
*City:
*State:
 
*ZIP:
*Home Phone:
*Cell Phone: