Breadcrumb

R'Card Request Form for Visiting and Non-Salaried Positions

Indicates required field

 

If your department needs an ID card for an affiliate with a Visiting and Non-Salaried Position, the person in the department who processes J-1 visas (or who oversees the on-boarding process) must fill out and submit this form on behalf of the affiliate. The Card Office staff will follow up with this visitor to request an ID photo and copy of a government-issue photo ID. (The Card Services office reserves the right to determine eligibility.)

The R’Card fee is $33.  Payment can be arranged by phone (951) 827-2211. We accept MasterCard, Visa and Discover. We do not accept cash.

Submit this form only if your affiliate will not receive an Employee ID number. Affiliates issued an Employee ID number must request their R’Card following the instructions for staff and faculty on our website.

Name of Department Administrator

Name of Department Administrator

Name of Affiliate

Name of Affiliate

If you provide a Lived/Preferred name, we will print this on your R’Card instead of your legal first name.
Please select the most appropriate STATUS
Purpose for which UCR ID Card is Requested

Select all that apply

Enter the name of the building or lab for which access is being requested.