FPC Employee Information Form - Frank Phillips College

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Employee Information Form

Name(Required)

First Last

Have you attended FPC or previously worked at FPC under a different name?(Required)

Yes

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

Address(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

Prefer not to answer

Status(Required)

Active

Reserve

Branch(Required)

Emergency Contact

In case of an Emergency, notify:

Name(Required)

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code

Cell Phone(Required)

Home Phone

Relationship(Required)

Upload Required Files(Required)

Required: Driver's License, Social Security Card, I-9 Form, and W-4 Form

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 GB.

Upload Other Files

Please upload the following files, if applicable: Worker's Compensation and Vehicle Agreement Form

Drop files here or

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

Grant Public Access to: Home Telephone Number(Required)

Yes

Grant Public Access to: Emergency Contact Information(Required)

Yes

Grant Public Access to: Family Member Information(Required)

Yes

Frank Phillips College

1301 W. Roosevelt | Box 5118
Borger, TX 79007
Telephone: (806) 457-4200

FPC Allen Campus

2314 S. Jefferson
Perryton, TX 79070
Telephone: (806) 648-1450

FPC Rahll Campus

2890 FM 281
Dalhart, TX 79022
Telephone: (806) 244-7669

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