Research Corporation of the University of Hawaiʻi

Research Corporation 3.610 UH/RCUH Faculty/Staff Identification Card of the University of Hawai‘i
Human Resources Department
UH-RCUH FACULTY/STAFF ID CARD APPLICATION FORM PLEASE PRINT LEGIBLY
NAME: ______________________________________________________________________________________ Last First Middle Initial
UH NUMBER: ___ ___ ___ ___ – ___ ___ ___ ___ EMAIL: ____________________________________________
I certify that I will surrender my UH ID to the RCUH Human Resources Department upon separation from the Research Corporation of the University of Hawaii.
____________________________________________ ________________________________________ Applicant’s Signature Date
RCUH Human Resources will review & certify your UH-RCUH Faculty/Staff ID card request. The completed/signed request form will be emailed to you. You must then take the completed form to the ID Office on your respective campus within one (1) month following RCUH’s authorization date. Please be sure to bring a valid photo ID (driver’s license, state ID w/expiration date, passport, etc.) in order to process your UH-RCUH ID application form. UH-Hilo regular status employees will be required to pay $5.00 (cash). UH-Hilo temporary staff will be required to pay $10.00 (cash).
The UH-RCUH ID card is valid for a maximum of 2 years and must be surrendered to the RCUH Human Resources Department upon separation of service. If you need to renew your ID card, you will need to fill out another ID application form.
Any lost ID card will be replaced at a cost of $15.00 (UH-Manoa) and $10.00 (UH-Hilo) to the Employee.
Please sign application form and scan/email to [email protected] or fax to RCUH Human Resources at (808) 956-9423.
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FOR RCUH PERSONNEL REPRESENTATIVE USE ONLY
 REGULAR (Core Staff Only – No Expiration) [No Charge UHM / $5.00 UHH]
TEMPORARY (Expiration) [$5.00 UHM / $10.00 UHH]
______________________
 REGULAR (Expiration)
[No Charge UHM / $5.00 UHH]
REPLACEMENT (Expiration)
[Replacement Charge: $15.00 UHM / $10.00 UHH]
EXPIRATION DATE (maximum 2 years)
I certify that the Research Corporation of the University of Hawaii (RCUH) employs the above named individual.
_________________________________________________ RCUH Personnel Representative (Signature)
_________________________________________________ RCUH Personnel Representative (Print Name)
RCUH Form E-18
Created 08/20/2007 (Revised 03/11/2011, 06/21/2012, 11/04/2013, 06/08/16)
________________________________ Date
________________________________ Phone #