Employee Information

  • Full Name: [Employee's Full Name]
  • Date of Birth: [Date of Birth]
  • Social Security Number: [Social Security Number]
  • Address: [Street Address, City, State, Zip Code]
  • Phone Number: [Phone Number]
  • Email Address: [Email Address]

Emergency Contact

  • Name: [Emergency Contact Name]
  • Relationship: [Relationship to Employee]
  • Phone Number: [Phone Number]
  • Alternate Phone Number: [Alternate Phone Number (if applicable)]

Employment Details

  • Position Title: [Position Title]
  • Start Date: [Start Date]
  • Work Location: [Work Location (if different from business address)]
  • Work Schedule: [Regular work hours and schedule]

Education and Work History

  • Education:
    • High School: [School Name, Year of Graduation]
    • College/University: [School Name, Degree, Year of Graduation]
    • Trade/Technical School: [School Name, Certification, Year of Completion]
  • Work Experience: List the employee's work experience, including:
    • Previous Employer: [Employer Name]
    • Position: [Position Title]
    • Dates of Employment: [Start Date - End Date]
    • Responsibilities: [Brief description of job duties]

Legal and Compliance Information

  • Employment Eligibility: Confirm the employee's eligibility to work in the USA. Attach copies of relevant documents (e.g., Form I-9).
  • Background Check: Confirm the completion of a background check, if applicable.
  • Drug Testing: Confirm the completion of a drug test, if applicable.
  • Drivers License: Confirm whether the employee has a valid driver's license, if applicable.

Health and Safety Information

  • Allergies: [Any known allergies]
  • Medical Conditions: [Any known medical conditions that may affect work]
  • Emergency Medical Information: [Any necessary emergency medical information]

Payroll Information

  • Bank Account Information: [Bank Name, Account Number, Routing Number]
  • Tax Information: [W-4 Form for Federal Withholding, State Withholding Form]

Acknowledgment and Consent

  • Employee Handbook: Confirm that the employee has received and read the employee handbook.
  • Safety and Training: Confirm that the employee has received necessary safety training.
  • Consent: Include any consent clauses, such as consent for background checks or drug testing.

Signature and Date

  • Employee Signature: [Employee Name and Signature]
  • Date: [Date]
  • Employer Signature: [Employer Name and Signature]
  • Date: [Date]