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Staff Resources

These forms are for the use of North Colonie Central Schools employees only.

Administrator Use Forms
Administrator Monthly Attendance Report (AANC/NIAANC/Mgmt-Conf)
Mileage Report (All Employees)
Claim Form (All Employees)
Request for Posting (RFP) (Hiring Managers)
Staffing Change Report (Managers/Supervisors)
Employee Counseling Memo (Managers/Supervisors)
Equipment for Bid
Non-employee incident report      
Field Trip/Extracurricular Trip Request Form

Attendance
Administrator Monthly Attendance Report (AANC/NIAANC/Mgmt-Conf)
Per Diem Administrator Weekly Time Sheet (AANC/NIAANC)
Substitute Registry Employee Quick Reference Card (AANC/NCTA)
Leave Donation Form (Mgmt-Conf/CSEA/NI/CSEA INSTR)
BOCES Sub Registry SmartFind Express

Benefits-EAP
Capital EAP Member Benefit Overview (All contracted)
Capital EAP Member Benefit Summary (All contracted)
Capital EAP Website Access Instructions (All contracted)
Capital EAP Wallet Card (All contracted)

Benefits-FSA
Flexible Spending Account Brochure (All contracted)
Flexible Spending Account Election Form (Contact HR-link will only be available during open enrollment for July 1 of each year.)
Flexible Spending Account Medical Expense Recovery Form (All contracted)
Flexible Spending Account Dependent Care Expense Recovery Form (All contracted)
Summary Plan Description

Benefits
Summary of Fringe Benefits Instructional Administrators (AANC)
Summary of Fringe Benefits Non-Instructional Administrators (NIAANC)
Summary of Fringe Benefits Instructional (NCTA)
Summary of Fringe Benefits Mgmt-Conf (Mgmt-Conf)
Summary of Fringe Benefits CSEA NI (CSEA NI)
Summary of Fringe Benefits Teacher/Computer Room Aides (CSEA INSTR)

Benefits-Insurance
Employee Benefits Enrollment Form (AANC/NIAANC)
Employee Benefits Enrollment Form (NCTA)
Employee Benefits Enrollment Form (Mgmt-Conf)
Employee Benefits Enrollment Form (CSEA NI)
Employee Benefits Enrollment Form (CSEA INSTR)
CSEA Employee Benefits Fund Proof of Student Status (CSEA NI)
Confirmation of Student Status (All contracted)
NCCSD Cafeteria Plan Summary Plan Description (All contracted)
Coverage Rights Under COBRA (All contracted)
ACA Notice

Benefits-In Lieu Of
In Lieu Of Reimbursement Form

Benefits-Health Insurance
Summary of Benefits and Coverage – CDPHP $25 copay (All contracted)
Summary of Benefits and Coverage – CDPHP $25/40 copay (CSEA INSTR)
Summary of Benefits and Coverage – MVP $25 copay (All contracted)
Summary of Benefits and Coverage – MVP $25/40 copay (CSEA INSTR)
Summary of Benefits and Coverage- NYSHIP (All contracted)
CDPHP Handicap Waiver Request (All contracted)
NYSHIP Handicap Waiver Request (All contracted)

Benefits-Dental Insurance
CSEA Sunrise Dental Enrollment Form (CSEA NI)
CSEA Sunrise Dental Plan Summary Plan Description (CSEA NI)-Contact HR
CSEA Sunrise Dental Plan Claim Form (CSEA NI)
Delta Dental Summary of Benefits- unlimited annual maximum (AANC/NIAANC/Mgmt-Conf)
Delta Dental Summary of Benefits $3,000 maximum (NCTA, CSEA INSTR)
Delta Dental Claim Form (AANC/NIAANC/NCTA/Mgmt-Conf)
Delta Dental Where’s my ID card?
Delta Dental Find a Network Dentist

Benefits-Vision Insurance
Davis Vision Benefit Description Brochure (AANC/NIAANC/NCTA)

Benefits-Life Insurance
Anthem Life Insurance Summary Plan Description Class 01 (All contracted except NCTA hired after 7/1/2010)
Anthem Life Insurance Summary Plan Description Class 02 (NCTA hired after 7/1/2012)
Anthem Life Insurance Beneficiary Designation Form (All contracted)

Benefits-LTD Insurance
First Unum Long Term Disability Summary Plan Description (AANC/NIAANC/NCTA/Mgmt-Conf)
First Unum LTD Claim Form (AANC/NIAANC/NCTA/Mgmt-Conf)

Benefits-Insurance Premiums
Ins. Premium Rate Sheet – AANC
Ins. Premium Rate Sheet – NIAANC
Ins. Premium Rate Sheet – NCTA
Ins. Premium Rate Sheet – Mgmt-Conf
Ins. Premium Rate Sheet – CSEA NI
Ins. Premium Rate Sheet – CSEA INSTR

Benefits-Insurance Extras
Anthem Life Insurance Resource Advisor Flyer (All contracted)
Anthem Life Insurance Special Offers Flyer (All contracted)

Benefits-Retirement 403(b)
What is a 403(b) Plan?
403(b) Universal Availability Notification (All employees)
403(b) Retirement Plan Document (All employees)
403(b) Salary Reduction Agreement (All employees)
Vendor List

Benefits-Retirement (Employee Retirement System)
Employees’ Retirement System (ERS) Member Registration (Mgmt-Conf/CSEA NI/CSEA INSTR)
ERS Name Change Notice (Mgmt-Conf/CSEA NI/CSEA INSTR)
ERS Designation of Beneficiary (Mgmt-Conf/CSEA NI/CSEA INSTR)
ERS Change of Address Form (Mgmt-Conf/CSEA NI/CSEA INSTR)
ERS Tier Booklets (All employees)

Benefits-Retirement (Teacher Retirement System)
Teachers’ Retirement System, (TRS) Application for Membership (AANC/NIAANC/NCTA)
TRS General Information
TRS Member Name/Address Change (AANC/NIAANC/NCTA)
TRS Designation of Beneficiary (AANC/NIAANC/NCTA)

Compensation
Direct Deposit Authorization Agreement (All employees)
Foreign Language Interpreter Compensation-Payment Directions
Form W-4 (All employees)
Form IT-2104, NYS Withholding Allowance Certificate (All employees)
2016-17 Pay Dates (All employees)
2016-17 Pay Schedule for non-contractual work (Non-contract employees)
Pay Check Preference (Payroll Data Form) (AANC/NCTA)
NYS Tax Certificate of Exemption from Withholding 
Tutor Timesheet

Employment Records
EEO/AA Voluntary Self Identification Form (All employees)
Emergency Contact Information (All employees)
Hepatitis B Vaccine Information Sheet (Available based on position)
Hepatitis B Vaccination Consent/Declination Form (Available based on position)
NCCSD Information Technology Access Release and Authorization (All employees)
NCCSD Infinite Campus Confidentiality and Non-Disclosure Agreement (Available based on position)
Request for Pesticide Application Notification (All employees)
Personal Data Change form for Non-Contractual Staff (Non-contract employees)
Application for CSEA Membership (CSEA NI/CSEA INSTR)
CSEA Employee Benefit Fund Change of Address Form (CSEA NI/CSEA INSTR)

General Interest
2016-17 School Calendar (All employees)
Conference Evaluation Form (All employees)
Staffing Change Report (Supervisors)
Hazard Communication Plan
Mileage Chart
Mileage Report (All employees)
Conference Request Form (All employees)
Claim Form (All employees)
Noon Aide Guide (Noon Aides)
United Way 211
In-service Credit Form 
Shaker Junior High School Teacher Handbook

Job Performance
Employee Counseling Memo (CSEA NI/CSEA INSTR)
Substitute Teacher Do Not Use Review Form (AANC)

Leave Request
Personal Leave Form (NCTA) 
Leave Donation Form
Leave Request Form (Mgmt-Conf)
Leave Request Form (CSEA NI)
Leave Request Form (CSEA INSTR/Instructions for Completing)
FMLA Leave Request Form (All employees)
NCTA FMLA/Maternity Leave Request Form (NCTA) 
Maternity Leave FAQ

Policies and Procedures
2015-16 Important Policies for Non-Instructional Appointed Employees (CSEA NI)
2015-16 Important Policies for Instructional Appointed Employees (AANC/NIAANC/NCTA)
2015-16 Important Policies for Non-Contractual Employees (Non-contract employees)
Drug Free Workplace (All employees)
Code of Ethics (All employees)
Employee Rights and Responsibilities Under FMLA (All employees)
Information Technology and Network Use Policy (All employees)
Policy Against Unlawful Harassment and Discrimination (All employees)
Basic Work Rules and Expectations (CSEA NI)
What to Expect When You’re Expecting

Recruitment
Interview Record (Hiring Managers)
Interview Report- Form A (Hiring Managers-Instructional Positions)
Interview Report- Form B (Hiring Managers-Instructional Positions)
Albany County Application for Employment (Based on position)
NCCSD Coaching Application (Coaches)
Request for Posting (Hiring Managers)
Verbal Reference Check- Instructional Applicants (Hiring Managers)
Verbal Reference Check- Non-Instructional Applicants (Hiring Managers)
Staffing Change Report (Hiring Managers)
NCCSD Employment Application (Non-Instructional)
Employment Application for Current Employees

Annual Notices
Certificate of Creditable Coverage 
CHIP Notice (2016) 
NYSHIP 2016 Creditable Coverage Notice

Union Contracts
Administrators Association of North Colonie (July 1, 2015 – June 30, 2018)
CSEA Instructional (July 1, 2015- June 30, 2018)
CSEA Non-Instructional (July 1, 2014 – June 30, 2017)
Instructional Support Administrators Association of North Colonie (July 1, 2015 – June 30, 2019)
North Colonie Teachers Association (July 1, 2014 – June 30, 2017)