Today's Date: [EFTA00003065]

as\nToday's Date: \nEmployee Name: \nPhysical Address: \nMailing Address: \nCell Phone: \nE-mail: \nTitle/Position: \nLSJE, LLC \n6100 Red I look Quarters, Suite 13-3, St. Thomas, VI 00802-1348 \nPhone: \nE-mail: thesaintjames.group@gmail.com \n110/21/18 \nPeter St Omer \nOperator \nAllergies or Health Concerns: \nBlood type: \nCurrent Medications: \nDoctor's Name: \nDoctors Name: \nN/A \nIn case of emergency, please contact \nName: \nName: \nkishma \n'Demers \nEmergency Contact Form \nRelationship: \nRelationship: \nFriend \n!Son \nStart Date: \nDate of Birth: \nPhone (other): \nMarital Status: \nDriver's license No: \nDoctors Phone: \nDoctor's Phone: \n!Married \nPhone: \nPhone: \nThis information is for your safety and the safety of others \nUnknown \nEFTA00003065\n\n--- Page Break ---\n\nas\nToday's Date: \nEmployee Name: \nPhysical Address: \nMailing Address: \nCell Phone: \nE-mail: \nTitle/Position: \nLSJE, LLC \n6100 Red I look Quarters, Suite 13-3, St. Thomas, VI 00802-1348 \nPhone: \nE-mail: thesaintjames.group@gmail.com \n110/21/18 \nPeter St Omer \nOperator \nAllergies or Health Concerns: \nBlood type: \nCurrent Medications: \nDoctor's Name: \nDoctors Name: \nN/A \nIn case of emergency, please contact \nName: \nName: \nkishma \n'Demers \nEmergency Contact Form \nRelationship: \nRelationship: \nFriend \n!Son \nStart Date: \nDate of Birth: \nPhone (other): \nMarital Status: \nDriver's license No: \nDoctors Phone: \nDoctor's Phone: \n!Married \nPhone: \nPhone: \nThis information is for your safety and the safety of others \nUnknown \nEFTA00003065