NEW ACT 24 CLEARANCE REQUIREMENTS

Memo to Employees

PA Department of Education Act 24 Notice to Schools

PDE 6004 Form

EMPLOYMENT AGREEMENTS
2009-2012 STEA Agreement Cover

2009-2012 STEA Agreement

OPEN ENROLLMENT FORMS

Benefits Briefing DCRA

Benefits Briefing HCRA

Administrator Open Enrollment/Insurance Selection Form

Professional Staff Open Enrollment/Insurance Selection Form

Executive Support Staff Open Enrollment/Insurance Selection Form

Flexible Spending Account Enrollment Form

Medical Insurance Opt Out Form

BLUE CARE PPO PLAN

Health Insurance Claims Assistance Information

Supplemental Dependent Form

BCNEPA Enrollment Application

2010/11 Blue Care PPO C Outline of Coverage

2010/11 Blue Care PPO E Outline of Coverage

2010/11 Blue Care PPO C & E Benefit Schedule

2010 PPO Insurance Changes (effective July 1, 2010)

        Prescription Drugs

        List of Maintenance Medications (attachment to Prescription Drugs)

2011 NTIC Insurance Changes Notice (effective July 1, 2011)

        Affordable Care Act Changes

EVALUATION FORMS

Professional Staff Evaluation Plan

Differentiated Evaluation Selection

Observation

Self-Directed Project

Professional Colloquium

Professional Portfolio

Focused Assistance Plan

Support Staff

PDE Evaluation Forms

PAYROLL FORMS

Time Sheet-all employees (Word doc.)

Direct Deposit Form (Word doc.)

W-4  2012  (PDF)

Certificate of Residency Form-2012

Local Services Tax (LST) Exemption Form

District Foundation Deduction Form

CO-PAY REIMBURSEMENT FORMS

Administration and Classified Staff

CWA Employees (paraprofessionals, cafeteria, custodian and maintenance)

MISCELLANEOUS FORMS

Credit Reimbursement Form

Expense Voucher

Act 48 Records Management System

Conference Request Form (Word doc.) (PDF)

Conference Report Form

Field Trip Request Form (Word doc)

Field Trip Permission Slip (Word doc) (PDF)

Extracurricular Bus Contract   (PDF)