MyErgo - New Account Request

Start Date*

dd

mmm

yyyy

Public Sector Employee?*

YesNo

Non-Public Sector Employees may not have access to this system. For more information contact the administrator using the Support link.

Employee First Name*

Employee Preferred Given Name

Employee Last Name*

Is the Employee Number available?*

YesNo

Employee Number*

Gender

Employee Email*

Position Title*

Competency Category*

Salary Class

Immediate Manager*

Manager Once Removed*

Comment

Name of person completing this form

(if different to the Employee Name above)

Email address of person completing this form

(if different to above)

Verfication