ARTHUR ACADEMY NEW EMPLOYEE PACKET
EMPLOYEE INFORMATION
First Name: Last Name: Middle Initial:
Birthdate: Social Security Number:
Phone Number: Secondary Phone Number:
Personal Email Address: Marital Status: Married Single Other:
ADDRESS
Street Address:
City: State: Zip:
MAILING ADDRESS - Same as above? Yes No (Complete below)
Street Address:
City: State: Zip:
EMERGENCY CONTACT INFORMATION
Primary Contact Name: Phone Number: Relationship:
Secondary Contact Name: Phone Number: Relationship:
OPTIONAL INFORMATION (Optional Information used only for State and School District reporting)
Gender: Female Male
Race/Ethnicity: White Black/African American Asian
American Indian/Alaska Native Hawaiian/Pacific Islander Other:
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