Hope College Confidential Employee Information Form
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1Hope College Confidential Employee Information Form
Please complete all information and return to the Human Resources office. Thank you!
1. Employee Name: ___________________________________________________________
2. Home Address: ____________________________________________________________
Street Address
____________________________________________________________
City
State
Zip
3. Home Phone Number: __________________
4. Birthdate: ______/_______/_______
5. Social Security Number: _____-_____-_____
6. Sex: Male
Female
7. Marital Status: Single
Married
Divorced
Separated
Widowed
8. Spouse and Dependent Children:
Relationship
Name
Birthdate
Social Security #
to Employee
9. Ethnicity (needed for Equal Employment reporting):
1) Is your ethnicity Hispanic and/or Latino?
Yes
No
2) If you answered no, please select the category below that best reflects your race:
□
□
□
Caucasian and/or White
Native Hawaiian or Other Pacific Islander
Asian
□
□
□
Black or African American
American Indian or Alaska Native
Multi-Racial
Emergency Contact Information:
1. Please provide a cell number (that you, the employee, would have with you during the day) for
the campus-wide emergency notification system. If you do not have one, please write ‘None’:
__________________________________________________________________________
2. Please provide the following information for an Emergency Contact Person:
Name: _________________________________________________________
Relationship to Employee:__________________________________________
Home Phone:____________________________________________________
Cell Phone:______________________________________________________
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Parent category: Business