{"id":2944,"date":"2017-11-19T01:31:34","date_gmt":"2017-11-19T01:31:34","guid":{"rendered":"http:\/\/10.3.0.224\/?page_id=2944"},"modified":"2025-10-21T09:22:05","modified_gmt":"2025-10-21T13:22:05","slug":"staff-information-forms","status":"publish","type":"page","link":"https:\/\/pvcsd.org\/index.php\/district\/district-info\/human-resources\/staff-information-forms\/","title":{"rendered":"Staff Information \/ Forms"},"content":{"rendered":"<h3>STAFF INFORMATION<\/h3>\n<ul>\n<li><a href=\"\/index.php\/district\/district-info\/appr-information\/\">Annual Professional Performance Review Documents<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/Prof_Development_Plan-2024-25_Final-BM-08-22-24.pdf\">PVCSD Professional Development Plan 2024 &#8211; 2025<\/a><\/li>\n<li><a href=\"https:\/\/www.pnwboces.org\/Files\/HBC\/Plan-Document-2020-NYSDFS-Approval-Pending.aspx\">Plan Document for PNW Health Benefits Consortium &#8211; NYSDFS Approval Pending<\/a><\/li>\n<li><a href=\"https:\/\/www.theeap.com\/employee-benefits-overview\">Employee Assistant Program (EAP) Information<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/Mentoring_Plan_2021_2022.pdf\">Mentoring Plan<\/a><\/li>\n<\/ul>\n<hr \/>\n<h3>STAFF FORMS<\/h3>\n<ul>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/pvft_anthem_dental_claim_form-rev_2019.pdf\">Dental Claim Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/pvft_vision_claim_form-rev_2019.pdf\">Vision Claim Form<\/a><\/li>\n<li><a href=\"\/index.php\/district\/district-info\/human-resources\/fmla-info\/\">FMLA (Family and Medical Leave Act)<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/Cigna_Beneficiary_Form.pdf\">Cigna Beneficiary Designation Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/0110-0113-Sexual_Harassment_Complaint_Form-Revised_2021.pdf\">Sexual Harassment Complaint Form<\/a><\/li>\n<\/ul>\n<hr \/>\n<h3>BUSINESS OFFICE FORMS<\/h3>\n<div class=\"pt-cv-wrapper\"><div class=\"pt-cv-view pt-cv-grid pt-cv-colsys\" id=\"pt-cv-view-efaaa7decy\"><div data-id=\"pt-cv-page-1\" class=\"pt-cv-page\" data-cvc=\"1\"><div class=\"col-md-12 col-sm-6 col-xs-12 pt-cv-content-item pt-cv-1-col\"  data-pid=\"10254\"><div class='pt-cv-ifield'><div class=\"pt-cv-content\"><ul>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/Name_Address_Change_Form_Rev_11_2022.pdf\">Address\/Name Change for PVCSD<\/a><\/li>\n<li><a href=\"http:\/\/pvcsd.org\/district\/pdf\/staff\/Address_Change_NYS_Teacher_Retirement_System.pdf\">Address Change for Teacher Retirement System<\/a><\/li>\n<li><a href=\"http:\/\/pvcsd.org\/district\/pdf\/staff\/Address_Change_NYS_Employee_Retirement_System.pdf\">Address Change for Employee Retirement System<\/a><\/li>\n<li><a href=\"http:\/\/pvcsd.org\/district\/pdf\/staff\/Cancer_Screening_Request_2022.pdf\">Cancer Screening<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/Claim_Form_rev_july_2021.pdf\">Claim Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/Club_Attendance_Form.pdf\">Club Attendance Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/CSEA_Vacation_Reimbursement_Request_2022.pdf\">CSEA Vacation Reimbursement Request Form<\/a><\/li>\n<li><a href=\"https:\/\/docs.google.com\/document\/d\/1iT5dUeJYPJMs9tcELJ1kP7YE4MQhlvSLAmmQBW_UcLA\/edit?usp=sharing\">CSEA Sick Leave Incentive Claim Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/QUOTE_WORKSHEET_TEMPLATE_OCT19_2021.docx\">District Quote Form<\/a><\/li>\n<li><a href=\"https:\/\/docs.google.com\/document\/d\/1AX0-GzjPQWrzGifw--vJEDlk0l-ur_XXC-CY2-UQCUw\/edit\">Field Trip Procedures<\/a><\/li>\n<li><a href=\"http:\/\/pvcsd.org\/district\/pdf\/staff\/FUNDS_TRANSMITTAL.pdf\">Funds Transmittal Form<\/a><\/li>\n<li><a href=\"http:\/\/pvcsd.org\/district\/pdf\/staff\/health_insurance_enrollment_declination.pdf\">Health Insurance Enrollment\/Declination Form<\/a><\/li>\n<li><a href=\"http:\/\/www.irs.gov\/pub\/irs-pdf\/fw4.pdf\">IRS Form W-4<\/a><\/li>\n<li><a href=\"https:\/\/www.tax.ny.gov\/pdf\/current_forms\/it\/it2104_fill_in.pdf\">NYS IT-2104 Tax Form<\/a><\/li>\n<li><a href=\"https:\/\/docs.google.com\/spreadsheets\/d\/1fVIfK8jVLSjRr9pYbYEFM44oNwz0_gS6vBWPQJd-MUA\/edit?ts=5d95fe34#gid=1561041649\">Overtime Claim Form &#8211; CSEA<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/Payroll_Schedule_25-26.pdf\">2025-2026 Payroll Schedule<\/a><\/li>\n<li><a href=\"http:\/\/pvcsd.org\/district\/pdf\/staff\/petty_cash_report.pdf\">Petty Cash Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/PVCSD_Purchasing_Policy_2021-22.pdf\">Purchasing Policy<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/PVCSD_PURCHASING_FLOWCHART.pdf\">Purchasing Policy Flow Chart<\/a><\/li>\n<li><a href=\"http:\/\/pvcsd.org\/district\/pdf\/staff\/Sick_Bank_Form_Fill_In.pdf\">Sick Leave Bank<\/a><\/li>\n<li><a href=\"https:\/\/www.sunmark.org\/\">Sunmark Credit Union<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/Vendor_Approval_Form_2023.pdf\">Vendor Approval Form<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><\/div>\t\t\t<style type=\"text\/css\" id=\"pt-cv-inline-style-7305212cnb\">#pt-cv-view-efaaa7decy .pt-cv-title a, #pt-cv-view-efaaa7decy  .panel-title { font-weight: 600 !important; }\n#pt-cv-view-efaaa7decy .pt-cv-content , #pt-cv-view-efaaa7decy  .pt-cv-content *:not(.pt-cv-readmore):not(style):not(script) { text-decoration: underline !important; }\n#pt-cv-view-efaaa7decy .pt-cv-readmore  { color: #ffffff !important; background-color: #00aeef !important; }\n#pt-cv-view-efaaa7decy .pt-cv-readmore:hover  { color: #ffffff !important; background-color: #00aeef !important; }<\/style>\r\n\t\t\t\n<hr \/>\n<h3>Professional Forms<\/h3>\n<ul>\n<li><a href=\"\/wp-content\/uploads\/resources\/district\/pdf\/staff\/Verification_of_Mentoring_Form_Rev_04_2022.pdf\">Mentoring Verification Form<\/a><\/li>\n<li><a href=\"http:\/\/www.highered.nysed.gov\/tcert\/pdf\/donotsubmit-ctlerecord.pdf\">Professional Development District Planning (175\/75 Hours)<\/a><\/li>\n<\/ul>\n<hr \/>\n<h3>Federal\/State Department of Labor Posters<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.ny.gov\/programs\/new-york-states-minimum-wage\">NYS Department Of Labor Minimum Wage<\/a><\/li>\n<li><a href=\"https:\/\/www.eeoc.gov\/sites\/default\/files\/2023-06\/22-088_EEOC_KnowYourRights6.12.pdf\">Equal Employment Opportunity is The Law<\/a><\/li>\n<li><a href=\"http:\/\/www.dol.gov\/whd\/regs\/compliance\/posters\/fmlaen.pdf\">Employee Rights and Responsibilities Under the Family and Medical Leave Act<\/a><\/li>\n<li><a href=\"http:\/\/www.dol.gov\/whd\/regs\/compliance\/posters\/minwagep.pdf\">Employee Rights Under the Fair Labor Standards Act<\/a><\/li>\n<li><a href=\"https:\/\/www.dol.gov\/sites\/dolgov\/files\/VETS\/files\/USERRA-Poster.pdf\">Your Rights Under USERRA (The Uniformed Services Employment and Reemployment Rights Act)<\/a><\/li>\n<li><a href=\"http:\/\/www.dol.gov\/whd\/regs\/compliance\/posters\/disabc.pdf\">Employee Rights for Workers with Disabilities Paid at Special Minimum Wages<\/a><\/li>\n<li><a href=\"https:\/\/dol.ny.gov\/workplace-safety\">Workplace Violence Prevention<\/a><\/li>\n<li><a href=\"https:\/\/elections.ny.gov\/time-vote\">New York State &#8211; Time Off to Vote at General Elections (Not School Budget Votes)<\/a><\/li>\n<\/ul>\n<h3><\/h3>\n<hr \/>\n<h3><a href=\"\/index.php\/district\/district-info\/human-resources\/admin-information-forms\/\">Admin Information\/Forms<\/a><\/h3>\n","protected":false},"excerpt":{"rendered":"<p>STAFF INFORMATION Annual Professional Performance Review Documents PVCSD Professional Development Plan 2024 &#8211; 2025 Plan Document for PNW Health Benefits Consortium &#8211; NYSDFS Approval Pending Employee Assistant Program (EAP) Information Mentoring Plan STAFF FORMS Dental Claim Form Vision Claim Form FMLA (Family and Medical Leave Act) Cigna Beneficiary Designation Form Sexual Harassment Complaint Form BUSINESS&hellip; <a class=\"continue\" href=\"https:\/\/pvcsd.org\/index.php\/district\/district-info\/business-office\/\">Continue Reading<span> Business Office Forms<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":2789,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[],"tags":[],"class_list":["post-2944","page","type-page","status-publish","hentry","clearfix"],"_links":{"self":[{"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/pages\/2944","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/comments?post=2944"}],"version-history":[{"count":75,"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/pages\/2944\/revisions"}],"predecessor-version":[{"id":17818,"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/pages\/2944\/revisions\/17818"}],"up":[{"embeddable":true,"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/pages\/2789"}],"wp:attachment":[{"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/media?parent=2944"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/categories?post=2944"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pvcsd.org\/index.php\/wp-json\/wp\/v2\/tags?post=2944"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}