Change in Personnel Information Change in Personnel Information
• Purpose/Instructions: In order to complete our personnel records and keep them up to date, we need the following personal information from you. Please fill in section I and II below. This information is for PHB personnel files only and will not be given out to any individual or organization without your consent. |
I. PERSONNEL INFORMATION
Effective Date _______________
Name
Address _____________________________________________________
City County ______________ State ___ Zip __ __
Home Telephone # ___________________
Other Telephone# ____________________
Email address _________________________________________________
II. EMERGENCY NOTIFICATION INFORMATION
Person to Notify _________
Relationship _______________
Daytime Telephone# _________________
Other Telephone# ___________________
Address _____________________________________________________
Email address ________________________________________________
Please fill in your new and/or updated information and return to Human Resources Department. This information will go into your personnel folder only. |