Current Employee Survey Preferred professional prefix First name Last name Spouse/Domestic Partner Preferred professional prefix Spouse/Domestic Partner first name Spouse/Domestic Partner last name (If different) Spouse/Domestic Partner Birthday i.e., 01/01/2013 Child Information Child 1 Name: Child 1 Birth Date: Child 2 Name: Child 2 Birth Date: Child 3 Name: Child 3 Birth Date: Child 4 Name: Child 4 Birth Date: Child 5 Name: Child 5 Birth Date: Relatives who also work at or attend(ed) PLU (If applicable) Alma mater (If not PLU) Notes or Comments Need assistance with this form?
