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Forms and Documents

Quick links to key forms.

Declination of Welfare Fund Benefits - All Benefits

Use this form to decline all Welfare Fund benefits for yourself and eligible dependents. You must sign this form and have it notarized.

Securing School Equipment

The following are proven hints and suggestions that will help to ensure that expensive equipment, including desktop and laptop computers, is kept safe and secure.

Dental Schedule

For Welfare Fund members who are using a non-participating dentist, your reimbursement will be according to this dental fee schedule; for those using a participating dentist, there will be no cost to the member except for co-pays listed in this...

Chancellor's Regulation A-449: Safety Transfers

This regulation sets forth the procedures for granting safety transfers (1) when students are victims of a violent criminal offense on school property; and (2) in other situations, when it is determined that a student’s continued presence in the...

Declination of Welfare Fund Benefits - Dental and/or Vision

Use this form to decline Welfare Fund dental and/or vision benefits for yourself and eligible dependents. You must sign this form and have it notarized.

DOE Advance overall ratings guide

A DOE guide to understanding your overall rating, for teachers covered under the Advance evaluation system.

Dentcare HMO brochure

Brochure for Dentcare HMO

Prescription Appliance and/or Medical Equipment Claim Form - HIP Subscribers Only

For HIP subscribers only, includes a section for member and physician to fill out. Please attach original, itemized, paid bill showing date and item purchased.

Provider/Program Enrollment or Update Request Form

Administration for Children's Services Division of Child Care/Head Start Child Care Support Services; Provider / Program Enrollment or Update Request

Documents required for dependent health benefits

List of supporting documents required for enrolling dependents in health benefits

Chemical Inventory Form

Form and instructions from the DOE Science Safety Manual.

RFA-1W (Request for Assistance by Injured Workers) - Workers Compensation form

File this form and any attachments with the Workers' Compensation Board when you want the board to take a specific action in your claim, or if you need to alert the board to any problem or situation that is affecting your claim. Many of the most...