Temporary Affiliate Form | Food Chain Cluster

Department

PI Full Name

Affiliate First Name

Affiliate Middle Name/Initial

Affiliate Last Name

Affiliate email

Additional email address - Non UC Davis

Reason for Affiliation

Affiliate Previous Student ID (if known)

This is particularly helpful for avoiding duplicate accounts, as the preferred action is to reinstate a persons previous account and email address.

Affiliate Previous Employee ID (if known)

This is particularly helpful for avoiding duplicate accounts, as the preferred action is to reinstate a persons previous account and email address.

Start Date

End Date

Maximum of 1 year past start date