Aesthetics New Employee Form

Employee Details

First Name: *

Middle Name(s):

Last Name: *

Street Address: *

Street Address 2:

City: *

State: *

Zip Code: *

Home Phone:

Cell/Mobile Number: *

Email: *

SSN: *

Date of Birth: *

Marital Status: *

Please specify: *

Role Information

Title: *

Employee ID: *

Supervisor: *

Department: *

Work Location: *

Work Email: *

Work Phone: *

Start Date: *

Salary: *

$

Emergency Contact Information

First Name: *

Middle Name(s):

Last Name: *

Do you share the same address as your emergency contact? *

Street Address: *

Street Address 2:

City: *

State: *

Zip Code: *

Primary Phone: *

Alternate Phone: *

Relationship: *

Direct Deposit Authorization

By completing this section, you consent for yoru employer to deposit your wages, minus applicable taxes, directly into your bank account on a week/bi-weekly/monthly basis. This section is not valid without the signature of the account holder.

Name of Account Holder: *

Bank Account Number: *

Routing Number (ABA/RTN): *

Name of Bank: *

Address of Bank: *

Signature: *

Tap or click on the signature above to sign