ࡱ> 796 bjbj ?$"  ]]]qqq84$qt!,$n]t"  c.L 8]rTE+i#qXD0t2$:$+$]+$t$ :  SEQ CHAPTER \h \r 1DAEMEN COLLEGE PERSONNEL DATA RECORD SECTION I ( Single ( Male Name: ( Married ( Female Street Address: City, State & Zip Code: Telephone ( Mail my paycheck Number: to the above address E-Mail Address: Social Security Number: Date of Birth: Highest Degree (HS or Equivalent (Master of: Completed: (Associates Degree (Doctor of: (Bachelor of: (Other: Date of Employment: Department: Previous 鶹AV College Employee: ( Yes ( No If so, when:  SECTION II In case of an emergency, please contact: Name: Relationship: Phone Number: To participate in the Emergency Notification System, please provide a cell phone number that will receive text messages or voicemails. This number will not be published: ( ) SECTION III To assist us in compliance with federal data collection requirements and the implementation of our affirmative action policy, select one or more categories that best describe your racial or ethnic heritage. This information is voluntary and not a prerequisite for employment. Are you Hispanic or Latino? ( Yes ( No ( Black or African American ( Native Hawaiian/ Other Pacific Islander ( Asian ( Vietnam Era Veteran/other covered Veteran ( Disabled ( American Indian or Alaska Native ( 2 or more races ( White     Revised March 2013 Please Note: Information for full time and part time staff, and full time administration and faculty is published in the Personnel Directory. If you would like your address and/or phone number unlisted, please check the appropriate area below. 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