Mt. Healthy City School District
Forms
Table of Contents


4000 - SUPPORT STAFF
4120f1New Employee Orientation Checklist
4120f2Custodial Interview Guide
4120df1Authorization to Contact Employment References
4120df2Information from Telephone Reference
4120.09f1Volunteer Release Form
4121f1Criminal History Statement
4122f2Staff Request for Reasonable Accommodation
4122f8Notice of Nondiscrimination and Grievance Procedures for Title II, Title VI, Title VII, and Title IX, Section 504, Age Act, and ADA
4122.01f1Certification Regarding Drug-Free Schools
4122.01f2Certification Regarding a Drug-Free Workplace
4122.01f3Memorandum to Staff Members on Federal Regulations Concerning Drug Prevention
4141f1Termination/Resignation Form
4160f1Emergency Medical Authorization Permit
4162f1Pre-Implementation and Program Review Checklist
4162f2Acknowledgement of Training
4162f3Authorization to Release Personal Information
4162f4Pre-Employment Controlled Substances and Alcohol Testing Consent Form
4220f1Secretarial Evaluation
4220f2Custodial Evaluation
4220f3Teacher Aide Evaluation Form
4231af1Participation in Political Activities
4242cf1Rating the Quality of a Staff Development Program
4362f1Report of Harassment
4421af1Request for Certificate of Health Coverage
4421af2Certificate of Group Health Plan Coverage
4430f1Personal Leave Notification
4430f2Emergency Personal Leave Application
4430f3Personnel Absentee Report
4430f4Parental Leave Form
4430f5Sabbatical Leave Form
4430f6Assault Leave Form
4430.01f1Family Leave Request Form
4430.01f2Certification of Health Care Provider
4430.01f3Family & Medical Leave Act (FMLA)
4440f1Mileage Reimbursement Request