HTML Preview Monthly Employee page number 1.
CONTRACT NO.:_______
Workforce Goal:___%
Workforce Plan
Monthly Employee Report (MER)
Reporting Period: From:_____ to ______
MDC/DBD
Reporting Period:
Percentage of Workforce Goal met:____%
Employee SS# Last Name
First Name Address City
Zip Code
Proof of
Residency
( specify types)
Classifification
hired for
Total hours
worked - this
period
Gross Earning -
prior month
Ethnicity Date of Hire End date CH
WRO(insert name
of WRO)
WDO (insert name
of WRO)
Self-Recuit 1 2 3
New hires this
period Put an
"X"
Executed by: _________________ DTA in which employee resides:
Signature of Affiant Sworn before me: Day of 200_
1= Recruited from DTA in which project is located.
_________________ ______________________________________ 2= Recurited from nearest DTA in which the projec
t
Printed Name of Affiant Notary Public 3= Recruited from another DTA other than 1 or 2.
Subcontractor
Primary Contractor
Subcontractor
Subcontractor
Subcontractor
From: __ To:__________________
Workforce Recruited From DTA
Legend:
WDO= Workforce Development Organization
WRO= Workforce Recruitment/Referral Organization
CH= Clearinghouse
Form: CWP-02
Revised 11/03