Faculty and Staff

Employee Forms

Continuing Education Form File updated: May 5, 2022

Extended Leave Request Form File updated: August 11, 2022

Federal Withholding Form W-4 File updated: January 24, 2023

Field Trip Forms File updated: May 5, 2022

Indiana Withholding Form WH-4 File updated: January 24, 2023

Paid Leave Form File updated: March 25, 2022

Payroll Direct Deposit Authorization Form File updated: January 11, 2022

Timesheet File updated: May 5, 2022

Travel Request Form File updated: January 11, 2022

Vehicle Request Form File updated: May 5, 2022

Anthem Application File updated: July 1, 2022

Anthem CERTIFIED File updated: November 29, 2022

Anthem CLASSIFIED File updated: November 29, 2022

HSA 1 Plan Summary File updated: April 26, 2022

HSA 2 Plan Summary File updated: April 26, 2022

PPO Plan Summary File updated: April 26, 2022

Pre-Dent Dental Benefits File updated: April 26, 2022

SISIT Benefits File updated: January 2, 2023

Vision Benefit Summary File updated: April 26, 2022

Vision Insurance Enrollment Form File updated: July 12, 2022

(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:

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

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

Labs List File updated: January 2, 2023

PreventiveRX Drug List File updated: January 26, 2023

Teacher Evaluation Plan File updated: January 6, 2022

Master Contract File updated: January 6, 2022

Superintendent Contract File updated: January 6, 2022

Families First Coronavirus Response Act (FFCRA) File updated: April 26, 2022