Monthly Employee
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CONTRACT NO.: Workforce Plan Monthly Employee Report (MER) Workforce Goal: MDC/DBD Reporting Period: From: to Reporting Period: From: To: Percentage of Workforce Goal met: Workforce Recruited From Employee SS Last Name First Name Address City Zip Code Proof of Residency Classifification ( specify types) 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 DTA 1 2 3 New hires this period Put an "X" Primary Contractor Subcontractor Subcontractor Subcontractor Subcontractor Executed by: Signature of Affiant Printed Name of Affiant Legend: WDO= Workforce Development Organization WRO= Workforce Recruitment/Referral Organization CH= Clearinghouse DTA in which employee resides: Sworn before me: Day of 200 Notary Public 1= Recruited from DTA in which project is located..
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