2. Instructions
   Please enter your name as it is on file with Cayuga County Civil Service. Current Cayuga County employees, please use the Human Resources Form. This form is not for City of Auburn Civil Service.
4. Are you a current Cayuga County employee?

   1. Yes, please go to Human Resource - Forms
   2. No, please continue
6. First Name (on file with Cayuga County Civil Service)*
7. Middle Initial (on file with Civil Service)
9. Last Name (on file with Cayuga County Civil Service)*
10. Suffix (on file with Civil Service)
    -- Select One --Sr.Jr.IIIIIIIVV
12. Change

    Choose the item(s) you want to change/update:

    1. Name
    2. Address
    3. Phone
    4. E-mail
14. First Name (update to)*
15. Middle Initial (update to)
17. Last Name (update to)*
18. Suffix (update to)
    -- Select One --JrSrIIIIIIIVV
20. Are your mailing and physical address*

    1. the same?
    2. different?
22. Mailing Address (update to)*
24. Mailing City (update to)*
25. Mailing State (update to)*
26. Mailing Zip Code (update to)*
28. Physical Address (update to)*
30. Physical City (update to)*
31. Physical State (update to)*
32. Physical Zip Code (update to)*
34. Home Phone (update to)*
35. Work Phone (update to)
36. Cell Phone (update to)
38. Email Address (update to)*
40. Attestation*

    1. I am the candidate listed above.
    2. I am submitting on behalf of the candidate listed above.
42. Name of person submitting form on behalf of the candidate*
43. Relationship to candidate*
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

* indicates a required field