Short Term Appointment Request

To:	Sherry Haley, Godzilla Trailer Rm. 114, MC 9505
From:	(Contact Administrator)

Visitor Name: Title/Affiliation:
CV Attached: Email ID Mail On File Fax (3-1882)

The department chair would like the sponsoring faculty to state the intended role expected of this visitor, including the reason this person is important to the laboratory:

Percent of effort:	%	Salary:
Account #:		Course no./quarter:
Social Security #:		Visitor's phone:
Visitor's office:		Visitor's email: