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Volunteer Handbook - Roper St. Francis Healthcare

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ID Badge Authorization FormType: <strong>St</strong>aff <strong>Volunteer</strong> Clergy Allied Barton Security <strong>Healthcare</strong> Parking Temp (Contract Dates: )Reason: New Name Change Title Change Broken/Not Working Lost<strong>St</strong>yle: <strong>St</strong>andard White ID Badge Pink ID Badge First Name OnlyFacility: Bon Secours <strong>St</strong>. <strong>Francis</strong> <strong>Roper</strong> Hospital Other:Legal Name:(First Name) (Middle Initial) (Last Name)Employee’s First Name (If other than Legal Name):Employee #Department Name:Corp # Department #:Employee’s Title: RN LPNChurch Name (Clergy <strong>St</strong>aff only): Give ID Badge to Employee Send ID Badge to Human Resources w/formSignature of HR/Manager Authorizing ID Badge(**HUMAN RESOURCES MUST SIGN FOR ALL RSFH STAFF NEW HIRES AND CHANGES**)DO NOT WRITE BELOW THIS LINENew ID Badge #Date:Note: Write the badge number of this form and fax the information to Human Resources and <strong>Healthcare</strong> Parking. Please verifybadge number for accuracy.

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