NEW EMPLOYEE ACCEPTANCE FORM by Ni18wJ0

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									                                             ACCEPTANCE FORM
                                          TO BE COMPLETED BY DIRECTOR
                                            PLEASE PRINT CLEARLY IN BLACK/BLUE INK

      [___] NEW HIRE                               DISTRICT # __________
      [___] REHIRE (within CNI)                                                    SCHOOL # _________
EMPLOYEE NUMBER:               [____] [____] [____] [____] [____] [____] [____] [____]
                                Last 4 of Social Security Number    Birth Month    Birth Day

EMPLOYEE’S FULL NAME __________________________________________________________
                                                    (NAME AS IT APPEARS ON SOCIAL SECURITY CARD)

BIRTH DATE _______________                         GENDER: [__] FEMALE            [__] MALE
MARITAL STATUS          [__] Single [__] Married

EMPLOYMENT SOURCE (Circle ONE only)                           DEPARTMENT:                       POSITION:
 Walk - In         Local Newspaper                                     (Circle ONE in Each column)
 Referral          CNI Web-site                               7001 Infants
 HR Staff Link     Career Builder                             7005 Toddlers                    Lead Teacher
 Employment Agency Other _____________                        7010 2 year olds
                                                              7015 3 year olds                 Teacher
START DATE (1ST day worked) ___________                       7020 4 year olds
                                                              7023 5 year olds                 Teacher’s Aide
EMPLOYMENT STATUS                                             7025 Schoolage
    [___] FULL TIME (25 hours or more per week)               7022 Funded Pre-K *              7060 Resource Coordinator
    [___] PART TIME (less than 25 hours per week)                            *GA Pre-K, More at Four, Bright Beginnings, etc. .
    [___] SUBSTITUTE                                          7055 Service                     Cook                        .
                                                              7035 Transportation              Van/Bus Driver
PAY TYPE                                                                                       Van/Bus Monitor             .
    [___] HOURLY [___] SALARY                                 7216 Maintenance                 Maintenance Technician      .
    (if salaried, put annual amount)                          7030 Administration              Director
RATE OF PAY $ _______________                                                                  Assistant Director
                                                                                               Lifeguard                   .
IF POSSIBLE DRIVER,                                           7090 Corporate                   District Manager
     Drivers License # _________________                                                       (other) ______________________
     State Issued ________________
               ADP Confirmation Number
   (Must be obtained on first day of employment)          __________________________

      FAX TO PAYROLL WITH           [] Race Ethnicity Form    [] W-4 [] State withholding form (if applicable)
           [] I-9 Page 11 Candidate Screening results with supporting documentation    [] Handbook Receipt
           [] Direct Deposit or Pay-Card Enrollment
  *****************ORIGINALS MUST STAY IN SCHOOL FILE*****************
  SCHOOL DIRECTOR SIGNATURE __________________________________________                         DATE _____________

  DISTRICT MANAGER SIGNATURE ___________________________________________ DATE ____________
                              (Required for all Pre-K staff and all rehires)
            ******* CREDENTIALS MUST BE ATTACHED FOR ALL PRE-K EMPLOYEES*******
                                                                                                                       0510
Here are some key points that need to be remembered when completing this form:

    THIS FORM IS COMPLETED BY THE DIRECTOR, NOT THE EMPLOYEE, on
     the first day of employment.

    If the employee previously worked at any CNI location, please check the rehire box.
     Call corporate to check rehire status before offering a position.

    The start date is the employee’s actual first day of work.

    The employees name must be the same as it appears on their Social Security card.

    The position and department must be circled. You may only circle ONE position
     and ONE department. If the employee may work in more than one department,
     that’s okay. Wherever the hours are keyed, this is where it will be charged on the
     General Ledger. The position/department is a default for the system if we have to
     prepare a manual check.

    If there is the slightest chance the employee will drive a company vehicle at any
     time, please list their drivers license number and state of issue where requested.

    The ADP/WOTC confirmation number must be obtained on the first day of
     employment.

    The entire form must be completed, including Director signature. Fax the front of
     this form to the payroll department with the following completed forms:

       [_] RACE/ETHNICITY FORM

       [_] CURRENT YEAR W-4 FEDERAL WITHHOLDING FORM

       [_] G-4 / A-4 / NC-4 / VA-4 (STATE WITHHOLDING – FL, SC, TN DO NOT HAVE ONE)

       [_] I-9 EMPLOYMENT ELIGIBILITY VERIFICATION

       [_] IDENTIFICATION USED FOR I-9 (i.e. DRIVERS LICENSE & SOCIAL SECURITY CARD)

       [_] HANDBOOK RECEIPT

       [_] DIRECT DEPOSIT OF PAY CARD ENROLLMENT

       [_] ANY OTHER REQUIRED PAPERWORK


    Keep the original in the employees personnel file at the school.

    The District Managers signature is required if the employee works in a Pre-K
     program or is a “Rehire”

								
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