LSJE, LLC [EFTA00003054]

LSJE, LLC \n6100 Red I look Quarters Suite B-S St. Thomas, VI 00802 Tel: \n(:ontact urm \nDate: \n03/20/18 \nEmployee Name: (Amy litre \nAddress: \n:A !homes VI 00802 \nDate of Birth: \nStart Date: \nPhone: \nCell \nE-Mail: \nn/a \nTitle / Position: Mathtenat.ce \nMarital Status: Married \nLicense: \nIllr4nergency Information: \nAllergies or Health Concerns. \nBlood Type: \nCurrent Medication: \nDoctor's Name: \nitc.: Il,,s I aiiiily \nPhone: \nDoctor's Name: \nPhone: \nIn case of an Emergency, Please contact: \nNavin \nValerie \nRelationship \nwife \nPhone \n/Sane \nCierrycia \nRelationship \nDaughter \nPhone \nThis Information is for your safety and the safety of others \nEFTA00003054\n\n--- Page Break ---\n\nLSJE, LLC \n6100 Red I look Quarters Suite B-S St. Thomas, VI 00802 Tel: \n(:ontact urm \nDate: \n03/20/18 \nEmployee Name: (Amy litre \nAddress: \n:A !homes VI 00802 \nDate of Birth: \nStart Date: \nPhone: \nCell \nE-Mail: \nn/a \nTitle / Position: Mathtenat.ce \nMarital Status: Married \nLicense: \nIllr4nergency Information: \nAllergies or Health Concerns. \nBlood Type: \nCurrent Medication: \nDoctor's Name: \nitc.: Il,,s I aiiiily \nPhone: \nDoctor's Name: \nPhone: \nIn case of an Emergency, Please contact: \nNavin \nValerie \nRelationship \nwife \nPhone \n/Sane \nCierrycia \nRelationship \nDaughter \nPhone \nThis Information is for your safety and the safety of others \nEFTA00003054