EMPLOYMENT VERIFICATION REQUEST
Fashion Institute of Technology
The Office of Human Resources
Seventh Avenue at 27th Street
New York City, 10001-5992

Date:   


I,    authorize the Office of Human Resources to release information concerning my employment status as indicated below by the checked items to the following establishment:   


ONLY INCLUDE INFORMATION CHECKED BELOW:

SOCIAL SECURITY NUMBER SALARY
START DATE:           FT        PT         ADDRESS
TITLE DATES FOR:            TENURE     or         CCE

If you are requesting that your social security number be included in this verification, you will be required to come to OHR with your employee ID and pick up the completed form.  OHR will not fax or mail any verification that includes a social security number until the employee has shown their ID card to an OHR representative.  There will be no exceptions.

Please contact me when my verification of employment has been completed at:



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