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Employees Only

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    Forms Icon     Click on the form name below to download the form you need.
     

     

     

     

     
    End of Year Employee Information  Letter
    2021 W4
    Change of Address/Phone
    Direct Deposit
    MASTER Health/Dental Enrollment-Change Form
    HSA Election Contribution Form
    Life Insurance Enrollment Form
    Waiver of Coverage Election Form
     
    ACT 48 Log
    Expense Voucher
    Personal Day Form
    Bereavement Day Request
    Pre-Approval for Comp Time
    Verification of Comp Time
    Release Time Request-Professional Development
    Release Time Request-Staff and Student Travel
    Requisition Form
    Vehicle Use Approval Form
     
    Graduate Credit Reimbursement Form
    Graduate Credit Pre-approval Form
     
    Timesheet-Admin Absence Report
    Timesheet-District
    Timesheet-Homebound Instruction (2 pages)
     Class Coverage Form HS 2019
    Class Coverage Form MS 2019
    Class Coverage Form ES 2019
    Mentor Packet Paperwork
    Mentee Packet Paperwork
     
    Applicant Approval Form 
    PA Standard Application
    District Support/Extra-Curricular Application
     
     
    Application Attachment
     
     
                         Required Clearance/Forms Information
    PDE-Act 114 FBI Fingerprint Requirements
    PDE Act 114 Service Code
    PDE Act 151 PA Child Abuse History Requirements
    PDE Act 34 PA State Criminal History Requirements
    Act 126 Mandated Reporter Training Information
    Act 168 Disclosure Release Form
    Act 24 Arrest and Conviction Report
    Local Wage Tax Residency Certification
    2021 Payroll Packet
     IT New Employee Profile Form
     
    403B Universal Availability-Info
    Delta Dental-Enrollee Notices
    Delta Dental Highlight Sheet
    Delta Dental Benefit Booklet
    Delta Dental SBC
    Highmark QHDHP Plan Summary
    Highmark QHDHP Benefit Book
    Highmark QHDHP SBC
    Uniform Glossary for SBC
    HSA Eligible Expense Listing
    HSA Account User Guide
     
    WC Panel
    WC-Employee Injury Kit
    Workman's Comp Decline Treatment Paperwork
    WC-Supervisor Checklist
     
    FMLA Request & Healthcare Prov Certification-EMPLOYEE
    FMLA Request & Healthcare Prov Certification-FAMILY MEMBER 
     
    Age 26 Coverage Update
    HIPAA Privacy Notice
    HIPAA Special Enrollment Notice
    Newborn & Mother Health Protection Act
    Women's HCRA
    Credible Coverage
     Health Parity
    CHIP Notice
     
     
    Safety Committee By-Laws
    Safety Concern Reporting Form
     
    Acceptable Use of Technology
     
    Student Activity-Cash Advance and Reconciliation Forms
    Student Activity-Request for Quotes
    Student Activity-Cash Deposit Settlement Sheet
    Student Activity-Sponsor Annual Report
    Student Activity-Fundraising Project Form
    Student Activity-Invoice Requisition Form
    Student Activity-Reimbursement Request
    Student Activity-Account Signature Card 19-20
     
    LST-exemption.pdf
    LST-refund form

     

Freedom Area School District

1702 School Street, Freedom, PA 15042

724-775-5464 724-775-7434

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