Hampshire County Schools - Official Website

Links to Forms - See Index above for quick links to each department or topic!

Attendance

*Student Residency Form - *required for enrollment for all students (may type & print)
Chronic Health Condition Statement
Request for Individual Exception to Attendance Requirement
Application for Out-of-School Attendance Area - Rev. 1/15
Application for Educational Leave for a Student - return to school principal

Application/Referral Form for Homebound Services
Homeless Notification Form - to report students who may be homeless
For proof of attendance for driver's licenses - contact the Superintendent's Office at 304-822--3528; ext 120

Discrimination/Harrassment

Employee Benefits/Insurance

PEIA Online Forms & Downloads (goes to Public Employees Insurance Agency web site)
American Fidelity Assurance Forms
AAA Membership Form

CompBenefits Forms:

Facility Use

Use of School Facility Request Form
Request for Use of Facility (HHS) - requires signatures of Principal & Athletic Director

Approved County Permission Slip/Form for Parents to Sign

Field Trip Permission Form

Finance/Payroll/Personal Leave

Time Sheets
- Time Sheet - Hourly - rev. 12/13
- Time Sheet - Service Personnel
- Time Sheet - More than 200-Day Contract
- Time Sheet - Bus Driver
- Overtime Authorization
- Long Term Substitute Report
- Teacher/Pupil Ratio (1st - 6th)
- Teacher/Pupil Ratio (Kindergarten)
- Homebound Instruction Record & Timesheet (PDF version)
- Homebound Instruction Record & Timesheet (Word 2007 version)
- Request to Work an In-Lieu Day (Word 2007 version)
- Request to Use an In-Lieu Day (Word 2007 version)
20/24 Payroll Selection Form - Select to get paid over 20 or 24 pays

Personal Business Day Request
- Request to use Personal Business Days(s) - Word version
- Request to use Personal Business Day(s) - PDF version
Personal Leave
Tax Withholding
- W4 Form - Federal
- W4 WV State Form
- W4 MD State Form
- W4 VA State Form
Banking - Direct Deposit

Free & Reduced Meal Applications & Payments

Applications @ http://wvschoolmeals.net
Payments @ https://wv.parentonline.net/

Fundraising

Fundraiser Application Form (rev. 7/13 to replace all old forms)
Cash Receipts Summary (pdf version to print)
Cash Receipts Summary (Excel version to complete on computer)
Fundraiser Profit/Loss Report Form
Auto-donor form for the public to donate to TAA
Auto-donor form for Hampshire County Board of Education Employees to donate to TAA

Health/Medical/Student Insurance

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

Personnel/Jobs

SearchSoft Online Job Application (on Teach West Virginia web site)
SearchSoft Employee Online Job Transfer Application (on Teach West Virginia web site)
All - Drug Free Workplace Verification Statement (required of all employees)

Volunteer Form- requires signature of principal at school where volunteering
Coaching - Authorized Certified Coaches Guidelines

Purchasing/P-Cards/Declining Balance Cards/Fundraising

Declining Balance Card Application (for Faculty Senate funds)
Declining Balance Card Procedures
Declining Balance Card Log rev. 7/2015 (Excel)

P (Purchasing)-Card Procedures
P(Purchasing)-Card Log rev. 4/2016 (Excel)

Safety/Maintenance

School Fire Exit Drill Safety Report - must be posted at all schools
School Dude Access
Custodial Supply Order Form - updated for 2014-15
Fire Drill Exit Safety Report Form
Unusual Incident/Accident Report Form - Student Revised
Unusual Incident/Accident Report Form - Employee Revised

School Enrollment - Parent Enrollment Checklist

Special Dietary Needs

Parent Letter of Information about Special Dietary Needs for Students
- Release of Information Statement (for back of Parent Letter)
Physician Letter of Information about Special Dietary Needs for Students
- Medical Statement by Physician (to be attached to Physician Letter)
- Definitions of Children with Disabilities and Special Dietary Needs (for back of Medical Statement

Staff Development

Staff Development Proposal Plan

Technology/Computers

FOR TEACHERS:

Transportation/Field Trips

Trip Request - 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!
Transfinder LE - for home connection
Transfinder LE - for school connection
Passenger Manifest (Word) - must be given to driver
Passenger Manifest (PDF)

NEW Bus Enrollment Form - to enroll new students in the transportation system
NEW In Lieu Application Form (2016-17) - request to transport student(s) in a personal vehicle
NEW In Lieu Monthly Documentation Form (2016-17) - monthly in lieu reimbursement form

Travel

Travel Request Form for In or Out-of-County Travel - (XLX form to type and then print) - must have an approved trip request to receive reimbursement.
Travel Request Form for In or Out-of-County Travel - (PDF form to print and complete by hand) - must have an approved trip request to receive reimbursement.

Reimbursement Forms

NEW Mileage Chart - $0.58 per mile after Jan. 1, 2019

In-County Expense Form for travel after Jan. 1, 2019 (Excel)

Out-of-County Expense Form for travel after Jan. 1, 2019 (Excel)

Old Mileage Chart for travel - $0.545 per mile before Jan. 1, 2019

In-County Expense Form for travel before Jan. 1, 2019 (Excel)

Out-of-County Expense Form for travel before Jan. 1, 2019 (Excel)

Volunteer Agreement Form

UPDATED Volunteer Form - updated 2018-19 - Please use this new
Also complete the following:
NEW TB Statement - required for all new employees and volunteers starting 2015-16

Worker's Compensation

Updated West Virginia Worker's Compensation Employee's and Physician's Report of Injury (for Brickstreet)
Hampshire County Unusual Incident Report NEW July 2017
Election of Option Form for Workers Comp

Live Edit