Employee Forms and Documents

In this section you will find all staff forms in use by the Springs UFSD. Select a category from below. You may then select the requested form by clicking on the name of the form. Please provide as much information about the vendor as possible.

Please fill out the form completely prior to submission.

• 403(b) UA Notice
• Employment Eligibility Verification
• Employee’s Withholding Allowance Certificate
• Employee’s Withholding Certificate
• Building Use Form
• Planned Absence Request Form
• Field Trip Request
  
• Conference
  
• Health, Dental and Payroll Forms
  
• Extracurricular Activity Forms
  
• Flex Plan
  
• Springs Bottom Lines for Reading

Requisition Forms 

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• REGULAR EDUCATION: SUBMIT REQUISITIONS TO: purchasing@springsschool.org
• SPECIAL EDUCATION: SUBMIT REQUISITIONS TO: sepurchasing@springsschool.org

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Field Trip Request

• Request for Approval of Field Trip
• Request For Approval of Field Trip (Spanish)
• Field Trip Form
• Field Trip Form (Spanish)
  
  

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Billheads

• General Billhead
  To be used for General Billhead submissions. Signature required from the department head prior to submission.
• Extracurricular Billhead
  To be used for Stipend Activities. Signature required from the department head prior to submission. 
• General Extra Hours
• ABA TUTORING BILLHEAD
• Custodial
• Custodial OT
• Transportation Form
• Transportation Form OT

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Conference

• Conference Expense Request
• Mileage Reimbursement

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Health, Dental and Payroll Forms

• Health Insurance Form (NYSHIP)
  
• Health Insurance Claim Form
• Health Insurance Enrollment/Changes
• Medical Enrollment
• Prescription Submission Form
• Dental Information
• Dental Form
• Direct Deposit Form
• Teacher Retirement Membership
• New York State Local Membership
• Federal Tax Witholding
• NY State Tax Witholding

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Extracurricular Activity Forms

• Request for Payment
• Supplies and Services
• Cash Receipt

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Flex Plan

• 2021 Healthcare Claim for Reimbursement
• 2021 Flexible Spending Cover Booklet
• 2021 Eligible Health Care Expenses
• 2021 Guidelines for Submission of a Claim
• 2021 Daycare Claim for Reimbursement
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Springs Bottom Lines for Reading 

• Springs Bottom Lines for Reading

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