LSJE, LLC [EFTA00003045]

LSJE, LLC \n6100 Red Hook Quarters. Suite B-3. St. Thomas. VI 00802-1348 \nPhone: \nE-mail: thesaintjames.group@gmail.com \nEmergency Contact Form \nToday's Date: \nEmployee Name: \nPhysical Address' \n10/15/18 \n}Carlos L Rodriguez \nStart Date: \nDate of Birth: \nThomas. VI 06802 \nro. Red Hook \na \nMailing Address. \nCell Phone: \nE-mail: \nU \nTitle/Position: \nFaotain \nPhone (other): \nMarital Status: \nDriver's License No: I.= \nlamed \nAllergies or Health Concerns: L \nBlood type: \nEl A- \nD A+ \nD AB- \nC AB+ \nEl g- \nEJ 8+ \no- \nD o+ \nQX Unknown \nCurrent Medications: r ime\nDoctors Name: \nDoctors Name: \nLivingston \nDoctors Phone: \nDoctor's Phone: \nIn case of emergency, please contact: \nName: \nName: \nRelationship: \nRelationship: \nPhone: \nPhone: \nThis information is for your safety and the safety of others. \nEFTA00003045\n\n--- Page Break ---\n\nLSJE, LLC \n6100 Red Hook Quarters. Suite B-3. St. Thomas. VI 00802-1348 \nPhone: \nE-mail: thesaintjames.group@gmail.com \nEmergency Contact Form \nToday's Date: \nEmployee Name: \nPhysical Address' \n10/15/18 \n}Carlos L Rodriguez \nStart Date: \nDate of Birth: \nThomas. VI 06802 \nro. Red Hook \na \nMailing Address. \nCell Phone: \nE-mail: \nU \nTitle/Position: \nFaotain \nPhone (other): \nMarital Status: \nDriver's License No: I.= \nlamed \nAllergies or Health Concerns: L \nBlood type: \nEl A- \nD A+ \nD AB- \nC AB+ \nEl g- \nEJ 8+ \no- \nD o+ \nQX Unknown \nCurrent Medications: r ime\nDoctors Name: \nDoctors Name: \nLivingston \nDoctors Phone: \nDoctor's Phone: \nIn case of emergency, please contact: \nName: \nName: \nRelationship: \nRelationship: \nPhone: \nPhone: \nThis information is for your safety and the safety of others. \nEFTA00003045