Summary of Benefits and Coverage
To be used when personal, professional, or sick leave do not apply.
To be used by any teacher requesting to take students off campus for an educational experience.
To be filed by any employee missing work to perform duties on a jury.
Job-Related - Scheduled during non-working hours)
To be filed by employee to transact business that cannot be performed outside of normal working hours.
To be filed when an employee is attending a conference or workshop where he/she is an officer of the organization.
To be used by employee for fundraiser request.
To be filed by employee attending a conference or workshop.
To be filed by employee when missing work due to illness of self or family member
To be filed by advisors or coaches at the completion of duties of extra-curricular activities. Please attach Supplemental Pay Withholding form.
To be used by employee requesting vacation time.
Certified Employee Life Insurance Certificate
Classified Employee Life Insurance Certificate
Eligible Board Member's Life Insurance Certificate
Grandfathered Healthcare Status/New Health Insurance Coverage Marketplace Options