LSJE, LLC
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel:
Emergency Contact Form
Date: 03/19/18 Start Date: 10/01/16
Employee Name: Oriole Joseph
Address: Date of Birth: 01/10/76
Phone: Cell: E-Mail:
Title / Position: Maintenance Marital Status: Single License:
Emergency Information:
unspecified
Allergies or Health Concerns:
Current Medication:
Doctor's Name: Phone:
Doctor's Name: Phone:
In case of an Emergency, Please contact :
Name Oscal Leil Relationship Cousin Phone 863-257-5611
Name Charles Victel Relationship Cousin Phone
This Information is for your safety and the safety ofothers
EFTA01223278