Online Forms

Index of Forms

Choose a topic to be taken to forms related to that department or subject:

• Attendance/Home Bound Schooling/Homeless/Home School
• Discrimination/HarrassmentEmployee 
• Benefits/Insurance
• Facility Use
• Field Trip Permission Slip
• Finance/Payroll/Personal Leave
• Free and Reduced Meal Applications and Payments
• Fundraising
• Health Form/Medical Release/Student Insurance
• Personnel/Jobs
• Purchasing/P-Cards/Declining Balance Cards
• Safety/Maintenance
• School Enrollment
• Special Dietary Needs
• Staff Development
• Technology/Computers
• Transportation
• Travel
• Volunteer Forms
• Worker's Compensation

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Links to Forms

Attendance

• Application for Out-of-School Attendance Area (PDF) - Revised January 2015
• Application for Educational Leave for a Student (DOCX)- return to school principal
• Application/Referral Form for Homebound Services (PDF)
• Chronic Health Condition Statement (PDF)
• Homeless Notification Form (PDF) - to report students who may be homeless
• Request for Individual Exception to Attendance Requirement (PDF)
• Notice of Intent to Home School (DOC)
• Student Residency Form (PDF) - required for enrollment for all students (may type and print)

For proof of attendance for driver's licenses - call Hampshire High School (HHS) at 304-822-5016, either Megan Fuller, ext. 1011 or Adam Feazell, ext. 1002.

Discrimination/Harassment

• Employee Report of Harassment Form (PDF)
  
• Student Report of Harassment Form (PDF)

Employee Benefits/Insurance

• AAA Membership Form (PDF)
• PEIA Online Forms and Downloads (goes to Public Employees Insurance Agency website)
• CompBenefits Forms:
  • Human Enrollment Form (PDF) Updated
  • Change Form - Vision or Dental (PDF)
  • Dental Claim Form (PDF)
  • Humana Vision Claim Form - Out of Network (PDF)

Facility Use

• Request for Use of Facility (HHS) (DOCX) - requires signatures of Principal and Athletic Director
  
• Use of School Facility Request Form (PDF)

Field Trip - Approved County Permission Slip

• Field Trip Permission Form (PDF)

Finance/Payroll/Personal Leave

• Payroll Forms and Time Sheets
  • Homebound Instruction Record and Timesheet (PDF)
  • Homebound Instruction Record and Timesheet (PDF)
  • Overtime Authorization (PDF)
  • Long Term Substitute Report (XLS)
  • Request to Use an In-Lieu Day (DOC)
  • Request to Work an In-Lieu Day (DOC)
  • Teacher/Pupil Ratio (1st to 6th) (DOC)
  • Teacher/Pupil Ratio (Kindergarten) (PDF)
  • Time Sheet - Bus Driver (XLS)
    
  • Time Sheet - Hourly (PDF) - revised December 2013
  • Time Sheet - More than 200-Day Contract (PDF)
  • Time Sheet - Service Personnel (PDF)
• 20/24 Payroll Selection Form (PDF)- Select to get paid over 20 or 24 pays
• Personal Business Day Request
  • Request to use Personal Business Days(s) (DOC)
  • Request to use Personal Business Day(s) (PDF) 
• Personal Leave
  • Donated Leave Form - Application to be a Recipient (DOC)
    
  • Personal Leave Bank Membership Form (PDF)
  • Personal Leave Bank Withdrawal Form (PDF)
  • Vacation Request (DOC)
• Ta Withholding
  • W4 Form (PDF) - Federal (2020)
  • W4 MD State Form (PDF)
  • W4 Virginia State Form (PDF)
  • W4 West Virginia State Form (PDF)
• Banking - Direct Deposit (PDF)

Free and Reduced Meal Applications and Payments

• Applications
• Payments 

Fundraising

• Auto-donor form (DOCX) for the public to donate to TAA
• Auto-donor form (DOCX) for Hampshire County Board of Education Employees to donate to TAA
• Cash Receipts Summary (PDF)
• Cash Receipts Summary (XLS) (Excel version to complete on computer)
• Fundraiser Application Form (PDF) (Revised July 2013 to replace all old forms)
• Fundraiser Profit/Loss Report Form (PDF)

Health/Medical/Student Insurance

• Emergency Procedure Card (PDF) - to be completed and sent to school to update information
• Medical Information Release Form (FERPA) (PDF) (may be typed, then printed and signed
• Medication Authorization Form (PDF)
• Student Accident Insurance Enrollment Forms, Instructions and Claim Forms - available from QBE Insurance Company

Personnel/Jobs

• All - Drug Free Workplace Verification Statement (PDF) (required of all employees)
• Coaching - Authorized Certified Coaches Guidelines (PDF)
• SearchSoft Online Job Application (on Teach West Virginia website)
• SearchSoft Employee Online Job Transfer Application (on Teach West Virginia website)
• Volunteer Form (PDF)- requires signature of principal at school where volunteering

Purchasing/P-Cards/Declining Balance Cards/Fundraising

• Declining Balance Card Application (PDF) (for Faculty Senate funds)
• Declining Balance Card Log (PDF) Revised July 2015 
• Declining Balance Card Procedures (PDF)
• P (Purchasing)-Card Procedures (PDF)
• P(Purchasing)-Card Log (PDF)Revised April 2016  

Safety/Maintenance

• Custodial Supply Order Form (PDF) - updated for 2014 to 2015
• Fire Drill Exit Safety Report Form (PDF)
• School Dude Access (PDF)
• School Fire Exit Drill Safety Report (PDF) - must be posted at all schools
• Unusual Incident/Accident Report Form - Student Revised (DOC)
• Unusual Incident/Accident Report Form - Student Revised (PDF)
• Hampshire County Unusual Incident Report (PDF) New 9/28/2021

School Enrollment

• Parent Enrollment Checklist (PDF)

Special Dietary Needs

• Children with Disabilities and Special Dietary Needs

Staff Development

• Staff Development Proposal Plan (PDF)

Technology/Computers

For teachers:

• Acceptable Use and Email Forms (PDF)
• End of Year Technology Checklist (PDF)
• Equipment Sign Out Form (PDF)
• Password Keeper Form (PDF)
• Technology Inventory Forms

Transportation/Field Trips

• Passenger Manifest (PDF)
• Passenger Manifest (RTF) must be given to driver
  
• Trip Request (PDF) - for initial use only if required by school - Do not send to the Board/Transportation as all trips must be entered in Transfinder by school for approval!
• New Bus Enrollment Form (PDF) (2021-2022)- to enroll new students in the transportation system
• New In Lieu Monthly Documentation Form (PDF) (2021-2022) - monthly in lieu reimbursement form
• New In Lieu Application Form (PDF)  (2021 to 2022) - request to transport student(s) in a personal vehicle

Travel Requests & Reimbursement Forms

• Travel Request Form for In or Out-of-County Travel (XLS) - Must have an approved trip request to receive reimbursement
• Travel Request Form for In or Out-of-County Travel (PDF) - Must have an approved trip request to receive reimbursement
• NEWMileage Chart (PDF) - At 58.5 cents per mile for travel after January 1, 2022
• Mileage Chart - (PDF) - At 56 cents per mile for travel before January 1, 2022 
• NEWIn-County Expense Form (XLSX) - For travel after January 1, 2022
• In-County Expense Form (XLSX) - For travel before January 1, 2022 
• NEWOut-of-County Expense Form (XLSX) - For travel after January 1, 2022
• Out-of-County Expense Form (XLSX) - For travel before January 1, 2022 

Volunteer Agreement Form  

• Updated Volunteer Form (DOC)- updated to 2021 22- Please use this new form
• Also complete the following:
  New Tuberculosis Statement (PDF) - required for all new employees and volunteers starting 2015 to 2016

Worker's Compensation

• Hampshire County Unusual Incident Report (PDF) New 9/28/2021
• Election of Option Form for Workers Compensation (DOC)
• Updated West Virginia Worker's Compensation Employee's and Physician's Report of Injury (PDF) (for Brickstreet)