AJEApp - Employee Onboarding - A&J Electric

Employee Onboarding

Welcome to A&J Electric! We are proud that you have decided to join our team. Please fill this form out fully so that we can enroll you in any benefits options you may need as well as have proper address and emergency contact information.

First Name *

Last Name *

Marital Status *

Spouse Name *

Phone *

Emergency Contact *

Phone *

Select *

Coverage Type *

Insurance & Benefit Options *Medical & Prescription DrugVisionDentalRetirement

Dependent Full Name

Dependent Full Name

Dependent Full Name

Dependent Full Name

Dependent Full Name

Dependent Full Name

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