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New Crewmember Demographics
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* Indicates required question
Legal First Name
*
Your answer
Legal Middle Name(s)
*
Your answer
Legal Last Name
*
Your answer
Preferred Name:
(What do you prefer to be called , if different than your legal name?)
Your answer
Preferred Username
*
This format follows the "firstname.lastname" convention. Note any changes to that, like if you always go by your middle name or a shortened version of your full first name (eg, Will.Smith instead of William.Smith).
Your answer
Personal cell number:
*
Your answer
Cellular Provider
*
Choose
Altell
AT&T
Boost Mobile
Cricket
Ntelos
Sprint PCS
T-Mobile
US Cellular
Verizon
Virigin Mobile
Other/not listed
What is the operating system of your personal phone?
*
(FFL has an app with protocols, policies, and checklists that we will send you a link to)
iOS
Android
Other:
Home Mailing Address
*
Your answer
Date Of Birth
*
MM
/
DD
/
YYYY
Personal email address:
*
A good email to use until your FFL email has been set up
Your answer
Confidential 4-digit PIN (numbers only)
*
To be used for narcotic safe access
Your answer
What is your official FFL start date?
*
Either your CTMF hire date if new employee, or official transfer date if already a CTMF employee
MM
/
DD
/
YYYY
Are you a current CHRISTUS employee?
*
Yes
No
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