Integrated Service Center

Employment Verification Request Form

Last updated Friday, May 22, 2020


  • Make sure you’re sending your employment verification request to the right place!
    The form below may not be relevant to your needs. Review the guidance on the Employment Verification Requests page for information on how/where to submit your request.


All fields are required unless otherwise indicated.






    Requestor's Info


    UW Employee's Info


    Between 2010-PresentBetween 2000-2009Between 1990-1999Between 1980-1989Between 1970-1979


    Current EmployeeFormer EmployeeStipend RecipientNorthwest Hospital EmployeeUW Physicians EmployeeUWNC Employee


    Check all that apply:
    Job TitleDates of EmploymentSalaryFull/Part-time StatusTemporary/Permanent Status

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