Department Request for Candidate Misconduct Disclosure and Authorization Release

Department Request for Candidate Misconduct Disclosure and Authorization Release

Please fill out the information below to initiate the disclosure and authorizations per SB 791 and AB 810 needed for candidates pending appointments. The accuracy of the information is imperative to ensure the candidate receives the correct form and the routing functions appropriately.
For GEPA, Do Not Use this Form and please reach out to sb791-gepa@ucsd.edu with any questions on the process for the Graduate Student Population.
Submitter Information

If you are filling out this form as a UCSD employee to begin a review process for a candidate, please use your information for this section.
Submitter Name (Are you filling out this form?) Place your email below:

First NameLast Name
Submitter Title
Submitter UCSD Email (Are you filling out this form?) Place your email below:

Confirmation EmailPlease confirm email by retyping here. Fill in fields are case sensitive.
Candidate Information

Please use the candidate's information for this section.
Candidate Full Name (As it appears on their application)

First NameLast Name
Candidate Email

Confirmation EmailPlease confirm email by retyping here. Fill in fields are case sensitive.
Hiring School
Department/Unit
Please don't type "Department of" - For example, you should type " Neurosciences"
Please enter the number associated with your recruitment. Preceding the number may be the letters ‘JPF’, or ‘SWR.' If no recruitment was utilized, please type in voluntary, change of series, or without-salary, as applicable.
Is the candidate being offered a position in either of these professorial series: Professor (Ladder-rank) or Professor of Teaching (PSOE/SOE) series at UCSD? (READ DESCRIPTION):
Answer ‘NO’ if the position you were offered is in any of these series: Visiting Professor/Scholar; Volunteer Clinical Professor; Professor of Clinical ‘X’; Health Sciences Clinical Professor/Instructor; Professor In Residence; Adjunct Professor; Unit 18 Lecturer; any other teaching or non-teaching title not mentioned. If unsure, please contact your hiring department. Postdoc Scholar
Should be Empty: