Personnel Form
Name:
Birthdate:
Project Staff No.:
Passport Number:
Citizenship:
Social Security No.:
Current Address:
Current Phone No.:
Address or Parents or Closest Living Relative:
Phone No. of Parents or Closest Living Relative:
Health Insurer:
Address of Insurer:
Identification No.:
In Emergency Notify:
Allergies (Food, Medication, Other):
Required prescription medications:
IF YOU ARE UNDER A PHYSICIAN’S CARE FOR A MEDICAL CONDITION, PLEASE ATTACH A DOCTOR’S LETTER TO THIS FORM THAT CERTIFIES THAT YOU ARE CAPABLE OF UNDERTAKING THE ACTIVITIES ASSOCIATED WITH THE CARACOL ARCHAEOLOGICAL PROJECT.