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

Indicates required field

Form Must Be Completed By Department Administrator

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.)

There is an R’Card fee and payment can be arranged below.

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

First

Last

Sponsoring Department

Administrator Email

Administrator Phone

Name of Affiliate

Legal First

Last

Lived/Preferred Name of Affiliate

If you provide a Lived/Preferred name, we will print this on your R’Card instead of your legal first name.

Affiliate's Contact Email

Affiliate's Contact Phone

Affiliation or Position they will occupy within the Department

UCR Start Date

UCR End Date

Please Select The Most Appropriate Status

R'Card Payment

Entity

Fund

Activity

Account

Function

Program

Project

Flex 1

Flex 2

Special Instructions for Card Office