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  • Emergency Contact Details Form

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    Benjamin Adams
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    The document requests emergency contact details from Benjamin Adams including the names, relationships, addresses and telephone numbers of two emergency contacts - his mother Ruth Adams and father Peter Adams. It states that all information provided will remain confidential and be processed according to data protection laws. Benjamin is asked to sign and date the form which is to be returned to the Human Resources department of Birmingham City University.

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    The document requests emergency contact details from Benjamin Adams including the names, relationships, addresses and telephone numbers of two emergency contacts - his mother Ruth Adams and father Peter Adams. It states that all information provided will remain confidential and be processed according to data protection laws. Benjamin is asked to sign and date the form which is to be returned to the Human Resources department of Birmingham City University.

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    © All Rights Reserved
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    11 views1 page

    Emergency Contact Details Form

    Uploaded by

    Benjamin Adams
    The document requests emergency contact details from Benjamin Adams including the names, relationships, addresses and telephone numbers of two emergency contacts - his mother Ruth Adams and father Peter Adams. It states that all information provided will remain confidential and be processed according to data protection laws. Benjamin is asked to sign and date the form which is to be returned to the Human Resources department of Birmingham City University.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    Emergency contact details

    CONFIDENTIAL

    Please complete the questions below and return the form to the Human Resources
    Department, Birmingham City University, First Floor, Joseph Priestley Building, 6 Cardigan
    Street, Birmingham B4 7BD. All information you provide will be treated in the strictest
    confidence and will be processed in accordance with the Data Protection Act 1998.

    1. Full Name…Benjamin Adams…………………………………………...

    2. Please state title by which you wish to be known: Professor/Dr/Mr/Mrs/Miss/Ms

    3. Are you receiving a Pension or Injury Allowance from a Local Authority or out
    of Public Funds? Yes/No

    4. Emergency Contact (1)

    Name Ruth Adams……Relationship Mother……………

    Address 1 Woodlands, Brookmans Park, Hatfield, Herts, AL9 7AN

    Tel: (Home) 01707649723……(Work) …………..……… (Mobile)…


    07748585462….

    5. Emergency Contact (2)

    Name Peter Adams……Relationship Father…………

    Address 1 Woodlands, Brookmans Park, Hatfield, Herts, AL9 7AN

    Tel: (Home) 01707649723………(Work) …………..……… (Mobile). 07843266317

    Signed

    Dated 14/03/2022

    LMc – 26/09/12

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