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Certificated Employment Packet

Certificated Employment Packet

The following employment documents are to be completed by newly hired certificated employees. Please print and complete the documents and contact Superintendent, Tom Dunn, or Melinda Hoffert at 937/339-5100 to schedule an appointment to review the documentation. You will need to bring your drivers license and social security card to your appointment.
Employee Medical Statement (for Preschool Employees ONLY)
 
Resident Educator Form
 
I-9 Employment Verification
 
Hepatitis B Vaccine
 
AESOP Profile Sheet
 
Employee Emergency Medical Authorization
 
Ohio Ethics Commission Form (READ ONLY)
 
Auditor of State Fraud Report System Information
 
Verification of Previous Employment
You will need to complete a separate verification form for each employer.
 
IRS W-4
 
Ohio IT-4
 
Public School Residence Form
 
Direct Deposit Form
 
Time to Enroll Flyer (Section 125 Handout)
 
Life Insurance Enrollment Form
 
2017 ESC Insurance Options Form w/HSA
This form allows you to view our insurance plans and indicate whether you wish to enroll/participate.  Also attached are instructions on how you will need to log onto Benelogic and enroll yourself and dependents in the insurance plans.
 
Retirement Enrollment Record for State Teachers Retirement System (STRS)
To be completed for new hire and/or retired-rehired employees.
 
Statement Concerning Your Employment in a Job Not Covered by Social Security (SSA-1945)