Non-Employee Associate Form (College of Medicine Only)

Instructions: After you fill this application the email will be send to Campus or Department for the appropriate approvals.

I, a Non-Employee Associate of Drexel University College of Medicine (DUCOM), require account access to DUCOM services ("Account Privileges") because I am a(n)


Demographic Information



The following questions are optional but assist in reports that we are required to provide to various agencies


Contact and Work Information



Primary Work Address



Home Address



I understand that I am not an employee of Drexel University and therefore I am not entitled to compensation or benefits of any kind, including, but not limited to, workers' compensation, unemployment compensation or health insurance. I understand that in receiving Account Privileges, I agree to abide by all Drexel University policies and procedures relating to the Services as may be in effect from time to time. Such policies and procedures can be found at https://drexel.edu/hr/resources/policies/ and www.library.drexel.edu/about/librarypolicies.html. I further agree that any violations of Drexel University's policies or procedures shall result in the immediate revocation of my Account Privileges. I understand that my Account Privileges shall be reviewed on an annual basis.

By submitting this form you are acknowledging that all information is correct


Either Campus or Department is required