Employee Information Form Name(Required) First Last Have you attended FPC or previously worked at FPC under a different name?(Required) Yes No If yes, please list previous name:(Required) First Last Social Security No(Required)Date of Birth(Required) MM slash DD slash YYYY Gender(Required) Male Female Marital Status(Required)NoneMarriedSingleWidowedDivorcedAddress(Required) Mailing Address City State / Province / Region ZIP / Postal Code Cell Phone(Required)Personal Email(Required) Ethnicity(Required) American Indian Asian Black/African Hispanic/Latino Native Hawaiian Non-Resident Unknown White Veteran(Required) Yes No Prefer not to answer Status(Required) Active Reserve Branch(Required)Emergency ContactIn case of an Emergency, notify:Name(Required) First Last Address Street Address City State / Province / Region ZIP / Postal Code Cell Phone(Required)Home PhoneRelationship(Required)Upload Required Files(Required)Required: Driver's License, Social Security Card, I-9 Form, and W-4 Form Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 1 GB. Upload Other FilesPlease upload the following files, if applicable: Worker's Compensation and Vehicle Agreement Form Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 1 GB. Texas Public Information Act (PIA)The name, sex, ethnicity, salary, title, and dates of employment of each employee is considered "Core Public Information" and will be released upon receipt of a public information request.Employees can choose whether to allow public access to the following information.Grant Public Access to: Home Address(Required) Yes No Grant Public Access to: Home Telephone Number(Required) Yes No Grant Public Access to: Emergency Contact Information(Required) Yes No Grant Public Access to: Family Member Information(Required) Yes No