Get Uab Benevolent Fund Eeap Intake Form

Completing the UAB Benevolent Fund EEAP Intake Form online ensures a streamlined process for requesting assistance. This guide provides step-by-step instructions to help you navigate the form effectively.

Follow the steps to fill out the form accurately.

1. Press the ‘Get Form’ button to obtain the form and open it in the designated editor.
2. Begin by providing your general information in the corresponding fields. This include your name, social security number, employee ID, and contact details such as address, phone numbers, and email. Ensure that all provided information is accurate and up-to-date.
3. Indicate your date of birth and marital status. Circle the appropriate options for both sections. Next, you will need to disclose your race and list all members of your household, including their names, ages, and occupations.
4. Answer the question regarding previous assistance from the UAB Benevolent Fund EEAP by selecting ‘Yes’ or ‘No’. Provide the name and phone number of a contact person in case of an emergency.
5. In the employment information section, fill in your position or title, hire date, total years employed at UAB, and current hours worked per week. Be sure to indicate your employment status.
6. Next, detail your current rate of pay and identify your employer by circling the appropriate organization. Specify your work location by selecting from the available options.
7. Carefully read the certification statement and confirm that the information you provided is true. Once you have read the statement, sign and date the form to complete your submission.
8. Finally, after completing the form, you have the option to save the changes, download, print, or share the form as needed.

Start filling out your UAB Benevolent Fund EEAP Intake Form online today!