Employee Information Sheet
Name:
Last First Middle
Full Time
Part Time
Temp
Address:
Street City State Zip Code
Sex: Education:
Male
Female
Social Security # High School College Other:
Date of Birth:
Grade School
Employee Payroll Number:
Total Years Worked:
From
To
Position
Department
Rate of Pay
Performance Review
Last Day Worked:
Reason for Departure:
In Case of Emergency Notify: Name: Address:
Street City State Zip Code
Relationship: Phone: