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| Click on the link, print the Member Enrollment package and fill it out. You will need a pdf viewer such as Adobe Acrobat to read the document. Click here to download Adobe. |
| MEMBER ENROLLMENT |
INCLUDES:
- EPI Member Enrollment Form
- INS Employment Eligibility Verification
- IRS Employees Withholding Allowance Certificate
- Georgia Employees Withholding Allowance Certificate
- Criminal and Medical Release Form
- Drug and Alcohol Consent Form
- Leased Employee Unemployment Information Form
- Workers Compensation Notice |
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