LSJE, LLC Red Hoo ers, Suite B-3, St. Thomas, VI 00802-1348 — E-mail: thesaintjames.group@gmail.com Emergency Contact Form Employee Name: [Donald Poilon bs | Date of Birth: Ke 6100 Phone J] A [AB [ AB+ oe [7 B+ oOo; 0 oO (CD Unknown Name is Relationship / Phone: _ = L : Ss Phone: This information is for your safety and the safety of others. EFTA00003050