Faculty and Staff

Employee Forms

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Continuing Education Form File updated: September 13, 2023
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Extended Leave Request Form File updated: September 13, 2023
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Federal Withholding Form W-4 File updated: September 13, 2023
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Field Trip Forms File updated: September 13, 2023
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Indiana Withholding Form WH-4 File updated: September 13, 2023
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Paid Leave Form File updated: September 13, 2023
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Payroll Direct Deposit Authorization Form File updated: September 13, 2023
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Timesheet File updated: September 13, 2023
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Travel Request Form File updated: September 13, 2023
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Vehicle Request Form File updated: September 13, 2023

    Doc Delivery

    Benefits

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    Anthem Application File updated: October 26, 2023
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    Anthem CERTIFIED File updated: March 5, 2024
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    Anthem CLASSIFIED File updated: March 5, 2024
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    Ascension St. Vincent Cardiovascular Care Program File updated: February 20, 2024
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    Hendricks Regional Health Info File updated: February 20, 2024
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    HSA 1 Plan Summary File updated: February 20, 2024
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    HSA 2 Plan Summary File updated: February 20, 2024
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    PPO Plan Summary File updated: February 20, 2024
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    Pre-Dent Dental Benefits File updated: September 13, 2023
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    SISIT Benefits File updated: January 2, 2023
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    Valic - Section 403(b) Salary Reduction Agreement File updated: August 15, 2022
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    Vision Benefit Summary File updated: September 13, 2023
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    Vision Insurance Enrollment Form File updated: July 12, 2022

      Anthem

      (800) 345-2460 for questions or issues. If not resolved, then please call Todd Nobbe at the administration building.

      To link to the Machine-Readable Files, please click on the URL provided:

      Valic

      John Kitlinski – (812) 212-5779 – john.kitlinski@valic.com
      Ryan Brown – (765) 620-6433  – ryan.brown@valic.com

      American Fidelity

      (317) 871-2480 or (800) 638-4268, ext 207

      Current Clinic Providers

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      Labs List File updated: September 13, 2023
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      PreventiveRX Drug List File updated: September 13, 2023

        Teacher Evaluation Plan

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        Teacher Evaluation Plan File updated: September 14, 2023

          Contracts

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          Master Contract File updated: November 14, 2023
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          Superintendent Contract File updated: September 13, 2023

            Classified Employees

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            Classified Staff Compensation and Benefits Package File updated: December 20, 2023

              Additional Resources

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              Families First Coronavirus Response Act (FFCRA) File updated: September 13, 2023