Temporary Employees and Independent Contractors Form

Please use the form below to add or delete temporary employees and/or independent contractors on the Member’s list of scheduled temporary employees and independent contractors. You will receive a confirmation email of your submission once you click the “Submit” button below. If you have any questions, please contact Melody Coons at mcoons@ncsba.org, 919-747-6684.

Submitter

Temporary Employee/Independent Contractor Information

Do you want to add, delete, or change a temporary employee/independent contractor?(Required)
MM slash DD slash YYYY

Affirmation

By signing below, you affirm that per the terms of the Board’s Automobile Liability Coverage Agreement with NCSBT, the temporary employee/independent contractor submitted above has a valid U.S. driver’s license required for the type of covered automobile to be driven without any court-ordered restrictions and this temporary employee/independent contractor meets all requirements set forth in Board policies, regulations, directives, or specifications.
Name(Required)