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Orange County Sportsplex <br />Employee Information Form <br /> <br />**** Please include a copy of social security card and driver’s license**** <br /> *** If under 18 years old, please include a copy of Youth Employment Certificate*** <br /> <br />Full Name: _________________________________________________________________________________ <br /> Last First M.I. <br />Address: _________________________________________________________________________________ <br />Street Address <br />__________________________________________________________________________ <br /> City State Zip Code <br />Primary Phone: __(______)______________________ Alternate Phone: __(______)______________________ <br />Email Address: ______________________________________________________________________________ <br />Social Security Number or Government ID: _______________________________________________________ <br />Birth Date: ________________________________ Marital Status: ☐ Single ☐ Married <br />Spouse’s Name: _____________________________________________________________________________ <br />Spouse’s Employer: ____________________________ Spouse’s Work Phone: __(______)_________________ <br /> <br />Full Name: _________________________________________________________________________________ <br /> Last First M.I. <br />Address: _________________________________________________________________________________ <br />Street Address <br />__________________________________________________________________________ <br /> City State Zip Code <br /> <br />Primary Phone: __(______)______________________ Alternate Phone: __(______)______________________ <br />Relationship: _______________________________________________________________________________ <br /> <br />Employee Title: ______________________________ Department: ___________________________________ <br />PrimePay Time-Clock Passcode: _________________ Supervisor: ____________________________________ <br />Start Date: __________________________________ Supervisor Email: _______________________________ <br />Pay Rate: ___________________________________ Supervisor Cell Phone: _(______)___________________ <br /> <br />General Manager Approval: ____________________________________________ Date: _________________ <br />Personal Information <br />Emergency Contact Information <br />Job Information (For Supervisor & HR Use Only) <br />Docusign Envelope ID: 177AA06A-30B4-42FF-A85A-78B5A7C51DBE