Staff Information Form

Please take a few minutes to provide us detailed information about yourself so MSS can compile and maintain accurate contact information for all Tenants/Staff/Employees within the building for law-enforcement, insurance and/or emergency notification and contact purposes.

Please note that Personal Identifying Information (PII) is for MSS Staff only and will NOT be shared with any individual or agency INSIDE or OUTSIDE of MSS.

Name Name Title First Middle Last Suffix
Home Address Home Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone Home Phone - ### - ### ####

The home number you provide is used for EMERGENCY PURPOSES only. This number will never be shared with anyone.
Mobile Phone Mobile Phone - ### - ### ####

The mobile number you provide is used for EMERGENCY PURPOSES or for MSS IT to provision and/or assist with your Microsoft account authentication. This number will never be shared with anyone.
Personal Email

The personal email address you provide is used for EMERGENCY PURPOSES only or for MSS IT to contact you via an alternate method than your agency address. This email address will never be shared with anyone.
In an Emergency, please contact:

Please provide name, work and mobile phone, email, relationship, etc of any those that should be contacted in an emergency.
I give MSS permission to share my birthday, favorite desserts and foods with others in MSS.

I give MSS permission to share my birthday, favorite desserts and foods with others in MSS. Yes No
Birth Month
Birth Day of Month
Favorite Desserts

Please be specific and give examples. You never know when you might be "treated"!
Favorite Foods

Please be specific and give examples. You never know when you might be "treated"!
Special Interests
Special Talents
Organization
Your Job Title
Upload a "Selfie"

Attach Files

Please upload a "selfie" picture that can be associated with your security access account and your MSS Skype for Business profile.