45
WRD
12
Figure WRD-12.1
Employee Personnel Form
© The Hub, Employee Personnel Form, version 1, <current date>
Employee Personnel Form
First Name
Last Name
Social Security
Date of Birth
Address
City
State
Zip
Phone Number
Cell Phone Number
Email Address
Spouse's Name (if applicable)
Phone Number
Cell Phone Number
Email Address
Emergency Contact Name
Phone Number
Days Available
Nights Available
Weekends Available
Holidays Available
T-Shirt Size (S, M, L, XL)
Shoe Size
Bank Name
Address
City
State
Zip Code
Direct Deposit yes no
Deposit Amount
Primary Beneficiary
Secondary Beneficiary
Employee Signature:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
For Evaluation Purposes Only