Staff Forms & Documents
FMLA - Leave Request Form
RHTA - Maternity/Childrearing Leave Notification pdf file type icon Download
Extended Leave or FMLA Request pdf file type icon Download

Group Insurance Documents
HSA Bank Website Guide pdf file type icon Download
EyeMed Out of Network Claim Form pdf file type icon Download
Life Insurance Beneficiary Change Form pdf file type icon Download
Point of Service (POS Plan) Summary of Benefits Nurses pdf file type icon Download
Point of Service (POS) Plan Summary of Benefits All others pdf file type icon Download
HSA Plan Summary of Benefits Coverage All Groups pdf file type icon Download
Healthcare Savings Account (HSA High Deductible Plan) Summary of Benefits pdf file type icon Download
Employee Guide to Flexible Spending Benefits pdf file type icon Download
Flexble Spending Eligible Expenses pdf file type icon Download
Flexible Spending Presentation pdf file type icon Download
Open Access Plus (OAP) Plan Summary of Benefits Coverage pdf file type icon Download
Open Access Plus (OAP Plan) Summary of Benefits pdf file type icon Download

Insurance Misc Medical Forms
Cigna Enrollment or Change Form pdf file type icon Download
CIGNA Claim Form pdf file type icon Download
CIGNA Annual Handicap Recertification Package pdf file type icon Download
HSA Direct Deposit Form pdf file type icon Download

Miscellaneous Forms
Mileage Reimbursement 2017 xls file type icon Download
Rocky Hill BOE W-9 Form pdf file type icon Download

Payroll Forms
Change of Name or Address pdf file type icon Download
2017 State CT W-4 pdf file type icon Download
2017 Federal W-4 pdf file type icon Download
2017 - 2018 Paydates pdf file type icon Download
CHET 529 College Savings Plan Deposit Form pdf file type icon Download
Direct Deposit Form pdf file type icon Download
403(b) Enrollment/Change Form pdf file type icon Download
22 or 26 Pay Selection pdf file type icon Download
Tutor Payment Form pdf file type icon Download
457 Plan Enrollment/Change Form pdf file type icon Download
Hourly Non-Union Pay Rates pdf file type icon Download
Annual Eligibility Notice 2017 and 403(b) Provider Listing pdf file type icon Download
Other Payment Form pdf file type icon Download
Extended Duty Payment Forms xls file type icon Download
Saturday Detention Payment Form pdf file type icon Download
Paperless Direct Deposit Sign Off pdf file type icon Download

Personnel and Hiring Forms
Personnel Request Form pdf file type icon Download
Personnel Recommendation Form pdf file type icon Download
Employee Reference Check pdf file type icon Download
Evaluation Non-Instructional Staff pdf file type icon Download
Evaluation Part-Time Paraprofessional pdf file type icon Download

Staff Forms
Field Trip Request Form docx file type icon Download
Retirement Application - Non Certified Staff pdf file type icon Download
Request for Conference Reimbursement Form docx file type icon Download
Request for Attendance at Professional Conference Form docx file type icon Download
New Course Proposal for 2017-2018 Budget Cycle doc file type icon Download
Curriculum Writing Request Form docx file type icon Download

Teacher Degree Approval/Tuition Reimbursement
2017-18 Tuition Reimbursement Form pdf file type icon Download
2017-18 Tuition Reimbursement Procedures pdf file type icon Download
2017-18 Degree Change/Salary Adjustment Form pdf file type icon Download
Degree Program Approval Form pdf file type icon Download
2016-17 Tuition Reimbursement Form pdf file type icon Download

Time and Attendance Aesop Instructions
Employee Guide English pdf file type icon Download
Employee Guide Spanish pdf file type icon Download
Substitute Guide English pdf file type icon Download
Substitute Guide Spanish pdf file type icon Download


How to use
Rocky Hill Public Schools Notice of Non-Discrimination

The Rocky Hill Board of Education prohibits discrimination or harassment on the basis of race, color, religious creed, age, marital status, military or veteran’s status, national origin, ancestry, sexual orientation and past or present learning disability, physical disability or mental disorder.  The Rocky Hill Board of Education provides equal access to the Boy Scouts and other designated youth groups.  The Rocky Hill Board of Education guarantees compliance under Titles VI and VII of the Civil Rights Act of 1964, Title IX of the Educational Amendments Acts of 1973, section 504 of the Rehabilitation Act of 1973, the American with Disabilities Act of 1991 and Connecticut General Statutes 46a-60.

The following person has been designated to handle inquiries regarding the non-discrimination policies:

Cathryn G. Riggs, Ph.D.
Director of Special Education and Pupil Personnel Services
761 Old Main St.
Rocky Hill, CT 06067
860-258-7705

For further information on non-discrimination, visit: http://www.hhs.gov/ocr/office/about/rgn-hqaddresses.html
for the address and phone number of the office that serves your area, or call 1-800-421-3481.