Miscellaneous Forms
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Business Card Request Form
Freshwater Education Foundation Donation Request Form
ID Badge Request Form
Invoice Notice Form
Invoice Notice Form with More Codes
Lamination Order Form
Photo Permission Form
PLC Action Plan
PLC Reflection Form
PLORD Documentation (Additional Work Day)
Purchase Requisition
Purchase Requisition for Special Ed Staff
Request for Donation
Vendor Claim Form
Non-Teacher Voluntary Reduction Form
Teacher Voluntary Reduction Form
Workshop Request Form
Insurance Information
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Enrollment Form and/or Change Form
NPJA HIPAA Privacy Notice2020 Insurance Plans
2020 ~ $1,000 Deductible Plan
2020 ~ $2,000 Deductible Plan
2020 ~ $5,000 Deductible Plan
Cobra Reference Chart2021 Insurance Plans
2021 ~ $1,000 Deductible Plan
2021 ~ $2,000 Deductible Plan
2021 ~ $2,800 Deductible Plan
2021 ~ $5,000 Deductible Plan
2021 Dental Rate Renewal
2021 Vision Rate Renewal
Employee Injury & Workers' Comp
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Process for reporting Workplace Injuries:
Workers' Compensation Insurance requires that injuries be reported immediately.Failure to do so may result in denied benefits.
- Employeecompletes “Employee Work Injury Report”. Employee should fax/email a copy of the Injury Report to the supervisor and send the original to the Business Office ~ The day of the incident
- Supervisor/or assistant completes“Supervisor Report of Injury” online and notifies Business Office of injury and completed Supervisor Report of Injury via email ~ Immediately upon notification of the incident
- If injured employee is being seen by physician he/she should take“Report of Workability” at the time of initial visit
First Report of Injury
To be filled out by employee the same day of the injuryReport of Workability
To be taken by injured employee if being seen by physician