Employment Data Form

INSTRUCTIONS:Fields outlined in red are required. Click "Submit" to send information.

Employee Information

The information requested below is needed to complete your employment processing. Please fill in the blanks with the information requested. Type your legal name as it appears on your Social Security Card.

Last Name

First Name

Middle Name

E-mail (Non WSU Tech email address)

WSU Tech ID

Date

Street Address

City

State

Zip

Home Phone

Cell Phone

Social Security #

Date of Birth

Demographic Information

Relatives at WSU Tech

If you are related to any person employed by WSU Tech, please list them below.

Relative's Name

Relationship

Military Status

No Military Retired Military Vietnam Era Veteran Other Veteran

In Case of Emergency Notify

Name

Relationship to Employee

Primary Phone

Secondary Phone

Please fill in required information above, then try again.