New Hire Registration Form
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POSITION INFORMATION:
GCSS Job Location *
Position Within GCSS *
Professional Standards Commission Account Number/Certification ID ("N/A" if not applicable) *
EMPLOYEE INFORMATION:
Date Of Birth *
MM
/
DD
/
YYYY
First Name *
Middle Name ("N/A" if no middle name) *
Last Name *
Marital Status *
ADDRESS:
Home Address - Street *
Home Address - Apartment Number
Home Address - City *
Home Address - State *
Home Address - Zip *
EMPLOYEE CONTACT INFORMATION:
Cell Phone (Enter "000-00-0000" if no cell phone) *
Home Phone (Enter "000-00-0000" if no home phone) *
Email Address *
OTHER INFORMATION:
Are You Coming From Another Georgia Public School *
If "Yes" above, Are You Currently Enrolled in State Health Benefit Plan (choose N/A if you answered no above) *
EMERGENCY CONTACT(S)
You must list at least one emergency contact
Emergency Contact 1 Name *
Emergency Contact 1 Relationship *
Emergency Contact 1 Phone *
Emergency Contact 2 Name
Emergency Contact 2 Relationship
Emergency Contact 2 Phone
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