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EFTA00003069.pdf
LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 Emergency Contact Form Date: 09/10/18 Start Date: 08/26/2018 Employee Name: Stephanie Remington Address: Phone: Title / Position: Asst to Manager Slergency Information: Allergies or Health Concerns: Blood Type: Current Medication: 18-1-3 Estate Smith Bey 00002 Cell: E-Mail: Marital Statu,, single License: Doctor's Name: Island Health 8, Wellness Center Phone Doctor's Name: In case of an Emergency, Please contact: Relationship Relationship Phone: Enema ''hone l'none This Information is for your safety and the safety of others EFTA00003069
EFTA00003022.pdf
EFTA00003022
EFTA00003100.pdf
EFTA00003100
EFTA00003050.pdf
Today's Date: Employee Name Physical Address: Isia:Eng Address: L Cell Phone E-mail: Title/Position: LSJE, LLC ( et's. Suite B-3. St. Thomas. VI 00802-1348 Pilot E-mail: thesaintjames.group@,gmaiI.com Emergency Contact Form 10/18/18 Donald Po4lon Start Date: Date of Birth: r Phone (other): Marital Status: Driver's License No: Allergies or Health Concerns: Blood tyoe: 7 A- D A+ 7 AB- D AB+ E Current Medications: Doctors Name: Doctor's Name: B- E 8+ 0 O- c o+ E Unknown in case of emergency, please contact: Name: Name: Relationship: Relationship: Doctor's Phone: Doctor's Phone: Phone: Phone: This information is for your safety and the safety of others. EFTA00003050
EFTA00003089.pdf
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EFTA00003039.pdf
N•R C Al Cu Dc Dc In ( Nar ;Aar -Dec 40 Coyvtle e Today's Date: Employee Name: Physical Address: Mailing Address: Cell Phone: E-mail: Title/Position: LSJE, LLC 6100 ers, Suite 8-3, St. Thomas, VI 00802-1348 Phone: E-mail: thesaintjames.group@gmail.com Emergency Contact Form Aiicitoias Vir4vitt Start Date: Date of Birth: Phone (other): Marital Status: Driver's License No: Allergies or Health Concerns: Blood type: A- D A+ K AB- O AB+ K B- O El+ D 0- E 0+ D Unknown Current Medications: Doctors Name: Doctor's Name: Doctor's Phone: Doctor's Phone: in case of emergency, please contact: Name, Name: Rclationahip. Relationship: Phone: Phone: This information is for your safety and the safety of others. EFTA00003039
EFTA00003027.pdf
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EFTA00003071.pdf
EFTA00003071
EFTA00003057.pdf
LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340.775-8108 Date: Employee Name: James Cesar Address: Phone: Emergency Contact Form Start Date: 05/04/17 Date of Birth: Cell: E-Mail: Title / Position: Carpenter Marital Status: Marne:: W mergency Info! n: Blood Type: ! Current Medication: Doctors Name: Doctor's Name: Phone: Phone: In case of an Emergency, Please contact : Relationship Relationship Phone This Information is for your safety and the safety of others EFTA00003057
EFTA00003081.pdf
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EFTA00003131.pdf
EFTA00003131
EFTA00003122.pdf
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EFTA00003121.pdf
EFTA00003121
EFTA00003079.pdf
EFTA00003079
EFTA00003099.pdf
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EFTA00003043.pdf
LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. I homes, VI 00802 Tell Fax: ." Date: 03/22/18 Employee Name: fivrilare Lot;da! • Emergency Contact Form Start Date: 03/22/18 Date of Birth: E-Mail: Marital Status: Married License: ergency Information: None Allergies or Health Concerns: Blood type unspecified Blood Type: Current Medication: Doctor's Name: Dodglas Doctor's Name: Dodglas Phone: Phone: In case of an Emergency, Please contact : Relationship Wife ..Memo Relationship In Law Phone Phone This Information is for your safety and the safety of others EFTA00003043
EFTA00003064.pdf
L LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 3 Date: 03 19:8 Employee Name: Pd rick L. Cena Address: Phone Title / Position: Captain i mergency Information: Allergies or Health Concerns: Blood Type: Current Medication: Doctor's Name: Doctor's Name: Emergency Contact Form Fax Start Date: 02t05/18 S.€ x 1 s vi 00802 Date of Birth: Cell: No blood type spectfied In case of an Emergency, Please contact : Name ante E-Mail: Marital Status: Divorce License: Relationship Phone: Phone: Father/Stepmother Phone Relationship Fnend Phone This Information is for your safety and the safety of others EFTA00003064
EFTA00003117.pdf
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EFTA00003048.pdf
LSJE, LLC 6100 Red [look Quarters Suite B-3 St. Thomas, VI 00802 Tel: ax: Date: )4'10/18 Employee Name: Deice Gusneme Address: Phone: le / Position- ..— L:41. ZIF.mergeocy Informal it Allergies or Health Concerns: Blood Type: Current Medication: Emergency Contact Form Start Date: Date of Birth:! E-Mail: Marital Status: Married License: Blood type not specified Doctor's Name: Pho►re: Doctor's Name: Phone: In case of an Emergency, Please contact : Relationship Sister Phone Relationship Phone This Information is for your safety and the safety of others EFTA00003048
EFTA00003106.pdf
EFTA00003106
EFTA00003088.pdf
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EFTA00003046.pdf
LSJE, LLC 6100 Red Hook Quarters Suite 8-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 Emergency Contact Form Date: OS is Start Date: Employee Name: Cristobal Hidalgo Herrera Address: Date of Birth: Phone Title / Position: Millikt.nergency Information: Cell: E-Mail: Marital Status Licen, Allergies or Health Concerns: Blood Type: Current Medication Doctor's Name: Doctor's Name: Sone 8:..xio type unspecified Phone: Phone: In case of an Emergency, Please contact : Relationship &other Phone Relationship Phone This Information is for your safety and the safety of others EFTA00003046
EFTA00003002.pdf
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EFTA00003070.pdf
NO a Today's Date: Employee Name: Physical Address, Mailing Address: Cell Phone: E-mail: LSJE, LLC 6I ok uarters. Suite 13-3, St. Thomas, VI 00802-1348 Phi E-mail: thesaintjamcs.group(a)gmail.com I mergency Contact Form 01/11/18 Sylvester Gaillard fide/Position: Kupenesor Allergies or Health Concerns: None riabetic Medications Current Medications: Doctors Name: Doctor's Name: Dr. Alah In case of emergency, please contact: Name: Name: St Thomas, V1 Relationship: Relationship: Stan Date: Date of Birth: StThomas, VI IMOther Phone (other): Marital Status: Driver's License No: Doctor's Phone: Doctor's Phone: Single Phone: Phone: This information is for your safety and the safety of others 0 Unknown 11 EFTA00003070
EFTA00003015.pdf
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EFTA00003136.pdf
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EFTA00003141.pdf
EFTA00003141
EFTA00003014.pdf
EFTA00003014
EFTA00003059.pdf
LSJE, LLC 6100 Red Hook Quarters, Suite 13-3, St. Thomas. VI 00802-1348 Phone: E-mail: thesaintjames.group(0,gmail.com Today's Date: Employee Name: Physical Address: Mailing Address: Cell Phone: E-mail: Title/Position: I5ngineer Emergency Contact Form Keshaun Moms Allergies or Health Concerns: Blood type: Start Date: Date of Birth: 10/01/18 Phone (other): Marital Status: Drivers License No: Current Medications: Doctor's Name: Doctors Phone: Doctors Name: Doctors Phone: In case of emergency, please contact: Name: Name: NM - 7 Relationship: Relationship: This information is for your safety and the safety of others EFTA00003059
EFTA00003108.pdf
EFTA00003108
EFTA00003049.pdf
LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 'H" Emergency Contact Form Date: 06/04/18 Employee Name: Danny Etienne Address: 'tvititE Title / Posit.:'i.: Ma • Start Date: Date of Birth: C tit E-Mail: Marital Status: Single License: Emergency Information: Allergies or Health Concerns: Blood Type: L Current Medication: Doctor's Name: Dodglas Phone: Doctor's Name: Dodglas Phone: In case of an Emergency, Please contact: Name Maria Relationship ame Relationship Etienne Phone Girlfriend Phone This Information is for your safety and the safety of others EFTA00003049
EFTA00003019.pdf
EFTA00003019
EFTA00003009.pdf
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EFTA00003095.pdf
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EFTA00003028.pdf
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EFTA00003116.pdf
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EFTA00003041.pdf
LSJE, LLC 6100 Red Hook Quarters, Suite B-3. St. Thomas. VI 00802-1348 Phone: E-mail: thesaintjames.group@gmaii.com Emergency Contact Form •••••••••• :y I He; r. dl at lam lam an E i Lou kie X Today's Date: -z - 9,e /9 Employee Name: I ) 9/e, R‘ks-isisTe Physical Address: Mailing Address: Cell Phone: Tide/Position: Start Date: Date of Birth: ,s0/4 5 or? ov-,2( rho/m.16 -1/ Phone (other): Marital Status: Drivers license No: Allergies or Health Concerns: I , Unitnc,,yr Current Medications: i Doctors Name: i Doctor's Name: Doctors Phone: Doctors Phone: In case of emergency, please contact. Name: I Relationship: Name: 7) etity )3>ovi c) - Relationship: Phone: This information is for your safety and the safety of others. EFTA00003041
EFTA00003044.pdf
LSJE, LLC 6100 • 1 sok uarters, Suite B-3, St. Thomas. VI 00802-1348 Phone: E-mail: thesaintjames.group@gmail.com Emergency Contact Form Today's Date: 110/17/18 Employee Name: Brian Bates Start Date: Date of Birth: Physic3! Address: Mailing Address: Cell Plior E-mail. Title/Position: IGOntrader Phone (other): Marital Status: Driver's License No: Single IM Allergies or Health Concerns: Blood type: El A- O A+ lE AB- El AB+ El 8- lit O O. El O+ Unknown Current Medications: h ne Doctors Name: Doctor's Name: Jamie Reed None Doctors Phone: Doctor's Phone: In case of emergency, please contact: Name: Name: Relationship: Relationship: Girlfriend Phone: Phone: This information is for your safety and the safety of others. EFTA00003044
EFTA00003112.pdf
EFTA00003112
EFTA00003132.pdf
EFTA00003132
EFTA00003094.pdf
EFTA00003094
EFTA00003066.pdf
3 LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tcl: Fax: Date: 03/25/18 Employee Name: Pierre Jules Address: Phone Title / Position: Emergency Contact Form Start Date: Date of Birth E-Mail: n limergency Information: n a Allergies or Health Concerns: Bloo0 type unspecified Blood Type: I _ Current Medication: Doctor's Name: rVa Doctor's Name: n/a Phone: n/a Phone: we In case of an Emergency, Please contact: Relationship Brother Phone Relationship Friend Phone This Information is for your safety and the safety of others EFTA00003066
EFTA00003145.pdf
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EFTA00003012.pdf
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EFTA00003125.pdf
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EFTA00003024.pdf
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EFTA00003144.pdf
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EFTA00003109.pdf
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EFTA00003083.pdf
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EFTA00003031.pdf
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EFTA00003098.pdf
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EFTA00003026.pdf
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EFTA00003038.pdf
LSJE, LLC 6100 Red Hook uarters, Suite B-3, St. Thomas. VI 00802-1348 Phone: E-mail: thesaintjames.group@gmail.com Emergency Contact Form Today's Date: Li_ _ 14 — 7_0 17 Employee Name: I ii(c Beiyhrt.S.6244 Physical Address: Mailing Address: Cell Phone: E-mail: Title/Position: Allergies or Health Concern I NI Start Date: Date of Birth: 3 - `1,5 -2-o lc/ -5C151-0, Phone (other): Marital Status: Driver's License No: Current Medications: 4 Doctors Name: Doctors Name: Doctors Phone. Doctors Phone: in case of emergency, please contact: Name — 1, Phone: Relationship —1-1Ce 4C1 Nam, Phone: I Relationship: 12 foth e y j This information is for your safety and the safety of others. EFTA00003038
EFTA00003152.pdf
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EFTA00003010.pdf
EFTA00003010
EFTA00003082.pdf
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EFTA00003001.pdf
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EFTA00003157.pdf
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EFTA00003129.pdf
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EFTA00003060.pdf
• 11 4 0 LSJE, LLC 6100 Red !look Quarters Suite B-3 St. Thomas, VI 00802 Tel: Emergency Contact Form Date: 03/19/18 Employee Name: Leiria fliornit t Address: Phone Coll- Title / Position: H emergency Information: Allergies or Health Concerns: Blood Type: Current Medication: Doctor's Name: Coorbin Doctor's Name: Coorbin Fax:: Start Date: Date of Birth: E-Mail: Marital Status: Married License: In case of an Emergency, Please contact: Relationship Marned Relationship Son Phone: Phone: Phone Phone This Information is for your safety and the safety of others EFTA00003060
EFTA00003062.pdf
LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: ay. Emergency Contact Form Date: 04 09 18 Start Date: Employee Name: Onel Pierresaint Address: Date of Birth: Phone: Cell: E-Mail: Title / Position: Marital Status: Married License: )nergency Information: Allergies or Health Concerns: Blood type uw.pe Blood Type: Current Medication: Doctor's Name: Rosa' Josemp Phone: Doctor's Name: Phone: In case of an Emergency, Please contact : Relationship SI' Relationship Wife Phone Friend Phone This Information is for your safety and the safety of others EFTA00003062
EFTA00003119.pdf
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EFTA00003133.pdf
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EFTA00003045.pdf
LSJE, LLC 6100 Red Hook Quarters. Suite B-3. St. Thomas. VI 00802-1348 Phone: E-mail: thesaintjames.group@gmail.com Emergency Contact Form Today's Date: Employee Name: Physical Address' 10/15/18 }Carlos L Rodriguez Start Date: Date of Birth: Thomas. VI 06802 ro. Red Hook a Mailing Address. Cell Phone: E-mail: U Title/Position: Faotain Phone (other): Marital Status: Driver's License No: I.= lamed Allergies or Health Concerns: L Blood type: El A- D A+ D AB- C AB+ El g- EJ 8+ o- D o+ QX Unknown Current Medications: r ime Doctors Name: Doctors Name: Livingston Doctors Phone: Doctor's Phone: In case of emergency, please contact: Name: Name: Relationship: Relationship: Phone: Phone: This information is for your safety and the safety of others. EFTA00003045
EFTA00003155.pdf
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EFTA00003113.pdf
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EFTA00003034.pdf
LSJE, LLC 6100 Red Hook Quarters, Suite B-3, St. Thomas. VI 00802-1348 Phone: E-mail: thesaintjames.group@email.com Emergency Contact Form Today's Date: Employee Name: Physical Address: Mailing Address: Cell Phone: E-mail: Title/Position: Start Date: Date of Birth: [IStimn We\ 6.11‘tv.tss 0,..b €)040 - Phone (other): Marital Status: Drivers License No: Allergies or Health Concerns: AJ gU Blood type: A- Di A+ D AB- D AB+ O B- B+ D o- Current Medications: Doctor's Name: Doctor's Name: 0 O+ 0 Unknown N/A In case of emergency, please contact: Name: Name: Relationship: Relationship: Doctors Phone: Doctors Phone: J Phone: Phone: This information is for your safety and the safety of others EFTA00003034
EFTA00003053.pdf
LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel ax: Date: 03/19/18 Employee Name: GaSJ Leatham Address: Phone: Title / Position: Landscapi"g Emergency Contact Form Start Date: Date of Birth: E-Mail: Marital Status: Single License: /4 4Thergency Informatioi, Allergies or Health Concerns: Blood Type: Current Medication: Doctor's Name: Doctor's Name: Phone: Phone: In case of an Emergency, Please contact: Name ),me Relationship Girlfriend Phone Relationship Sister Phone This Information is for your safety and the safety of others EFTA00003053
EFTA00003140.pdf
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EFTA00002552.pdf
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EFTA00003068.pdf
LSJE, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel Fax: Date: 04/09/18 Emergency Contact Form Start Date: Employee Name: Date of Birth: Address: Phone: E-Mail: Title / Position: Marital Status: License: lmergency Information: Allergies or Health Concerns: Blood Type: Current Medication: Doctor's Name: Phone: Doctor's Name: Phone: In case of an Emergency, Please contact: Relationship Phone Relationship Pastor phone This Information is for your safety and the safety of others EFTA00003068
EFTA00003115.pdf
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