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Get UH Form 64B 2015-2024

S: Street Apt. # Email address: Middle Initial City State Zip Code Preferred phone #: Please indicate: Cell Work Home Complete the following if you are presently or were formerly employed as an APT within the University of Hawai‘i: Department/College: Official Position Title: Present or Last APT Appt Period: Business phone: Full Time or Part Time Bargaining Unit 08 (HGEA) or Excluded Unit 78 (non-union) Check one of the following boxes if you are exercising employment right.

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