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Employee Data Sheet

Please correct the field(s) marked in red below:

1

Clay County BCC – Employee Data Sheet

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2

Employee Information

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Employee Information
3

Spouse Information

4

Children Information (Please include the child's telephone number if they are not living at home.):

Children Information (Please include the child's telephone number if they are not living at home.):
5

Emergency Contact Information

Please list two emergency contacts and their telephone numbers where they can be reached at during the day.

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Emergency Contact Information Please list two emergency contacts and their telephone numbers where they can be reached at during the day.
6

Emergency Information

Please list any other information that may be helpful in case of an emergency.  This includes medical conditions such as allergies, etc. *


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