Establishing a Professional Affiliate Policy - Northern Michigan University

Note:  The applicable form is attached as a word doc near the top of this document.  

PURPOSE

Establish a process for approving a formal professional affiliation between Northern Michigan University (NMU) and an individual or a representative of an organization.

PROCEDURES

To initiate a Professional Affiliate designation, the following steps must be completed:

1. Offices, departments, and employees requesting a Professional Affiliate designation for a person or organization with no current NMU affiliation must complete the Professional Affiliate Request & Approval form.
2. The office manager, director, or department head must provide a rationale and specify the start and end dates for the Professional Affiliate designation in accordance with the Establishing a Professional Affiliate policy.
3. The desired privilege(s) requested for the Professional Affiliate must be clearly identified on the request form.  To receive these privileges the Professional Affiliate must also complete any necessary attendant forms.  The Professional Affiliate must read all NMU policy statements identified on the Professional Affiliate Request & Approval form (listed under References), and must agree to abide by these policies.  Professional Affiliate request forms must be signed by the NMU sponsoring office’s administrator and the individual to be designated as Professional Affiliate before being forwarded to the next administrative level.
4. The request must be approved by the appropriate NMU Vice President or by the President as stipulated in the Establishing a Professional Affiliate policy.
5. Upon approval, information regarding the individual receiving the Professional Affiliate designation will be entered into an NMU database.  Information in the database will include name, mailing address, and phone number of the Professional Affiliate.
6. A Professional Affiliate agreement may be renewed.  The Professional Affiliate Request & Approval form must be updated along with the database record indicating the revised designation end date.  Personal information regarding the individual should be updated as necessary. 

Upon approval, the completed Professional Affiliate Request & Approval form will be sent to Information Technology, with a copy to Human Resources, for processing. 

REFERENCES

NMU Computer Network Acceptable Use Policy

NMU Password Policy

NMU Intellectual Property Policy

NOTE:  The following text matches the attached word document (which is a little lower on the form and called attached proceure file1).  If you need to print the form, use the word file attached further down on this page.    

NORTHERN MICHIGAN UNIVERSITY

PROFESSIONAL AFFILIATE

REQUEST & APPROVAL FORM

Professional Affiliate Information:

Last Name:  ______________________________________________________________

First Name: ______________________________________________________________

Address:  ________________________________________________________________    

Contact Phone Number:  ____________________________________________________

Current Email Address: _____________________________________________________

Organization/Institution name: ________________________________________________

NMU Office/Department Seeking Approval for a Professional Affiliate:

Department/Office: _________________________________________________________   

Campus Address /  Phone: ___________________________________________________                                   

Administrator (e.g. Department Head, Director, Dean, Associate Vice President):

Last Name:  _____________________________________________________________      

First Name: ______________________________________________________________

Position:  ________________________________________________________________ 

Phone:  _______________________________________________________________         

NMU E-mail address:  ____________________________________________________

Purpose of the Professional Affiliation:

Start date:                                         

End date (no greater than 3 years):                                   

Privileges Requested for Professional Affiliate (include rationale for each request)

NMU Computer Network User ID                            Yes ___                No ___

                Rationale: 

NMU Photo ID Card                                                  Yes ___                No ___

                Rationale: 

Parking                                                                      Yes ___                No ___                

                Rationale: 

Required Signatures

Individual receiving a Professional Affiliate designation:  I attest that I have read all of the NMU Policy Statements identified as “References” on the Professional Affiliate Request & Approval form, and I agree to abide by the rules and regulations described.

Professional Affiliate:  ____________________________  Date:  ____________

Department Head/Director, Dean, Associate Vice President: I agree to ensure that the Professional Affiliate is aware of applicable policies regarding the use of NMU resources.

Department Head/Director:

­­­­­­­­­­­­­­­­

_____________________________________________      Date:  ____________

College Dean or Senior Management:

______________________________________________    Date:  ____________

APPROVAL

Executive Administrator (Vice President or President):

______________________________________________    Date:  ____________

REFERENCES

NMU Computer Network Acceptable Use Policy

NMU Password Policy

NMU Intellectual Property Policy

NMU Motor Vehicle Ordinances

ACKNOWLEDGMENT

I understand that by accepting Professional Affiliate designation at Northern Michigan University I am merely being given access to specific, limited NMU resources (e.g. computer network, parking) to aid my professional association with NMU.  Except for such resources, I recognize that I am entitled only to the same rights and protections as any other NMU visitor.

Recognizing that NMU is not my employer, I acknowledge and understand that I will not be paid wages by NMU.  I recognize and acknowledge that if I become ill or am injured while engaged in the professional affiliate activities, while utilizing NMU’s resources, or while on NMU’s property, that NMU provides no remedy.

I take full responsibility for my actions and/or behaviors while using NMU’s resources or while on NMU property.  I understand that my “privileges” are limited to those identified in the Professional Affiliate Request & Approval form, that I am entitled to use only those NMU resources identified in the Professional Affiliate Request & Approval form, and that I will abide by the Policy Statements listed on the Professional Affiliate Request & Approval form.  I specifically understand that NMU’s responsibility and/or liability for my actions and safety while on NMU property is no greater or different than NMU’s responsibility and/or liability to any other campus visitor.

I recognize and understand that NMU can discontinue my Professional Affiliate designation at any time and for any reason. 

____________________________      ___________________________________________
Date:                                                      Professional Affiliate: