Continue an earlier submission
.
2019 Session Employee
First Name:
Middle Initial:
Last Name:
Prefered Name:
Home Address:
Street:
City:
State:
Zip:
County:
Phone:
Phone Type:
.. Please Select ..
Cellular Phone
Home Phone
Email:
Session Address:
Is your Session Address different from your Home Address?
.. Please Select ..
Yes
No
Street:
City:
State:
Zip:
County:
Phone:
Phone Type:
.. Please Select ..
Cellular Phone
Home Phone
Emergency Contact:
First Name:
Last Name:
Relationship:
Phone:
Phone Type:
.. Please Select ..
Cellular Phone
Home Phone
Position:
.. Please Select ..
Administrative Assistant
Committee Clerk
Committee Intern
Staff Assistant
Page Supervisor
Page Supervisor - Asst.
Doorkeeper
Journal Staff
Page Chaperone
Page Tutor
Postmaster - Asst.
Supply Clerk
Receptionist
How will you arrive to work?
.. Please Select ..
Personal Vehicle
City Bus (GRTC)
Have you worked for the Senate of Virginia in the last 3 years?
.. Please Select ..
Yes
No
Has your Payroll Direct Deposit Bank Information changed since you were last paid by the Senate?
.. Please Select ..
Yes
No
Are you required to register for Selective Service? (Males Only)
.. Please Select ..
Yes
No
