Employee Records Update Form
Full Name
*
First Name
Last Name
NIS Registration Number
*
Please enter your NIS Registration No. Eg. 1234567. Avoid formats such as 01234567 or 0123456-7.
Contact Details
Home Contact No.
Please enter a valid phone number.
Primary E-Mail Address
*
Please enter your primary e-mail address.
Mobile Contact No.
*
Please enter a valid phone number.
Other E-Mail Address
Please enter your secondary e-mail address.
Work Contact No.
Please enter a valid phone number.
Address Details
Address Line 1
*
Please enter an address. Eg. Bay Gardens
Address Line 2
Please enter an address. Eg. St. Paul's
Town
Please Select
ST GEORGE'S
GRENVILLE
GOUYAVE
VICTORIA
SAUTEURS
HILLSBOROUGH
Please select a town.
Parish
*
Please Select
ST PATRICK
ST DAVID
ST JOHN
ST ANDREW
ST MARK
ST GEORGE
CARRIACOU
Please select a parish.
Overseas Address (if applicable)
Street Address
Apt/Suite/Other
City
Postal/Zip Code
Please verify that you are human
*
Submit
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