FAMILY RELATIONSHIP DISCLOSURE FORM
Employment Date: ______________________________ Full-Time □ Part-Time □
Salary Schedule: Rank: Step: Annual Salary:
For the purposes of disclosure, relative includes any person related within the fourth degree of
affinity or consanguinity to any job, position, or office of profit with state or with any of its
Are you a relative of any employee of the Alabama Community College System or any member of
the Alabama Community College System Board of Trustees?
Yes □ No □
If yes, list the name(s), relationship, and employer or the position of the relative(s)
My signature below affirms that all information contained herein is correct to the best of my
Employee’s Name Printed Employee’s Signature
*Please see reverse side for an illustration defining relatives to the fourth degree.
Revised September, 2017