Employee Data Collection Sheet printable pdf download

EMPLOYEE DATA

COLLECTION SHEET

Please complete all the information below. Questions about this collection of personal information

should be forwarded to the Manager of Human Resources.

First Name: _____________________________ Last Name: _______________________________

As listed on your SIN card

Preferred Name: (e.g. Bob, Jen) _____________ Prefix: (e.g. Mr., Mrs., Miss., Ms.) ______________

Social Insurance Number: _________________ Birth Date: _______________________________

Phone Number: (Home) (____) _____ - __________

(Cell) (____) _____ - _________

Home Address: __________________________________

Apt. /Unit # ________________

City: ___________________________________________

Postal Code _______________

Mailing Address; (if different from your home address)

________________________________________________

Apt. /Unit # ________________

City: ___________________________________________

Postal Code _______________

Email Address: _________________________________________________________________

Emergency Contact :(e.g. Smith, Jane) ___________________________________________

Relationship to Contact: _______________________________________________________

Phone Number: (Business) (____) _____ - __________ ext. # __________

(Home) (____) _____ - __________

(Cell) (____) _____ - __________

Other Language _____________________ Speak

Read

Write

Photo Consent:

I give Central West CCAC permission to post my photo ID picture on the Intranet and/or use any

photographs(s) including my likeness in any and all publication or communication including, but not

limited to newsletters, brochures, displays, reports and websites

I do not give Central West CCAC permission to post my photo ID picture on the Intranet and/or

use any photographs(s) including my likeness in any and all publication or communication including,

but not limited to newsletters, brochures, displays, reports and websites

H:\Orientation\Onboarding\PreBoarding Forms\EMPLOYEE DATA COLLECTION.docx

Employee Data Collection Sheet