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Herscher CUSD #2

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Staff Forms

Welcome to our Staff Forms page!

When submitting any of the following documents, please remember to keep a copy for yourself.


Purchase Order Information
Purchasing and Cash Handling Procedures
New Vendor Request Form (Obtain and attach their W9 form)
BLANK W9 (Need from new vendors. Return to UO)Inserted Image
Our Tax Exempt Letter
Our W9 Form (2016)
School Specialty Order Instructions
Staples Order Instructions
Request for Purchase Order (2020)
Check Request (2020)
American Express P-Card Expense Report (2020)
BMO Mastercard P-Card Expense Report (2020)

Questions regarding purchase orders can be directed to Kristin in Accounts Payable at 815-426-2162 or via email at milligank@hcusd2.org 

Insurance Information / Documents
The Herscher School District is part of the Educational Benefit Cooperative (EBC).

OPEN ENROLLMENT for 2024-2025 opens TODAY!  
May 3-13, 2024
Should you experience a qualifying life event, please contact Payroll/HR at 815-421-5016

Online Enrollment Guide 

24-25 Insurance Rates
EBC Summary for 2024-25
EBC Admin Manual rev 10.2023

Open Enrollment Presentation from AJGallagher: https://www.brainshark.com/gallagher/vu?pi=zGizjb7G8zlAXQz0

BCBS Dental Benefits Highlight Sheet  - LOW Plan
Dental Low Policy Document
BCBS Dental Benefits Highlight Sheet- HIGH Plan
Dental High Policy Document

HSA PPO Summary of Benefits and Coverage (SBC) 24-25
HSA Frequently Asked Questions
HSA PPO Handout
HSA Salary Reduction Agreement 2024
Questions about allowable expenses under the HSA? Click here for a helpful website. 

HRA PPO Summary of Benefits and Coverage (SBC) 24-25
HRA PPO Handout
HRA Deductible Reimbursement Form 24-25 * Send w/ your EOB that states the amount met of your deductible to the Unit Office Attn: H. Crane
**The district does not reimburse Out-Of-Pocket expenses.**

HRA Deductible Reimbursement Form 24-25
Insurance Waiver 24-25. Remember to Waive coverage ONLINE and submit proof of other coverage. 
Transparency in Coverage

Voluntary Life and Accidental Death & Dismemberment (AD&D) Plan Highlights  
Reliance Voluntary Life Rates 
Reliance Voluntary Accidental Death and Dismemberment (AD&D) Rates 

EyeMed Benefits Sheet
EyeMed Out-Of-Network Claim Form for mailing 

Identify Theft Brochure
Travel Assistance Flyer
EBC MyCHoice Mobile App  

Women's Health and Cancer Rights Notice
CHIPRA State Premium Assistance Notice
Title IX Information

Payroll/Human Resources Documents
2023-2024 Pay Days
2024-2025 Pay Days
403b Meaning Notice 2024
Plan Participation Guide 2024 
Annual Retirement Benefit Guide 2024
403b Salary Reduction Agreement 2024
403b ROTH Salary Reduction Agreement 2024
457b Salary Reduction Agreement 2024 
403b Investment Website
409-A Annualized Compensation Form (CERT)
Application Signature Page
AUP Acceptable Use Policy 

Bookkeeping/Payroll Form Instructions
DCFS Mandated Reporter Acknowledgment Form 
Direct Deposit Form/Instructions. Must receive hard copy. 
Drug and Alcohol-Free Workplace. Board Policy 5:50
Employee Information Form - Use to update your personal information with UO.
Employee - First Report of Injury Form/Instructions 
Extra Pay Sheet (CERT) Music Dept ONLY 
Extra Pay Sheet (CERT) Not Music Dept NEW/UPDATED for 2023-2024SY

Extra Pay Sheet - Certified (Non-Music) - 2024-2025SY
Extra Pay Sheet (NON-CERT) NEW/UPDATED for 2023-2024 SY
Extra Pay Sheet - Non-Cert - 2024-2025SY
Fingerprint Form - All Staff  - - - EXCEPT bus drivers
Fingerprint Form - Bus Drivers ONLY! 
Harassment and Sexual Misconduct Policy

IDES new hire reporting form
I-9 Form and Instructions - updated 8/2023
IMRF Voluntary Additional Contribution Make/Change Form

Employer Cost & Participation Information (IMRF): https://www.imrf.org/en/about-imrf/transparency/employer-cost-and-participation-information
Non-Certified Staff. Irrevocable Notice of Intent to Retire. 2023-2028
Personal Day Request Form
Personnel Recommendation Form - PDF - - - USE AFTER JULY 1, 2023 
Personnel Recommendation Form - WORD - - - USE AFTER JULY 1, 2023 
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Physical Exam Form
Standards and Procedures for Staff
Statement Concerning Employment in a Job Not Covered by Social Security

W-4 Illinois. Must receive hard copy. 
W-4 Federal (2024). Must receive hard copy.
     Click here to view latest tax tables. Click here for more information.

      Questions about your federal withholding? 
     Click here to view 2024 method percentages for automated payroll systems 
         This helpful tool compares Single vs Married vs Head of Household as well as Standard vs. if the box in Step 2 (on new Fed W4) is checked.

Contract Links
PERA Overview  
PERA Public Acts  

Miscellaneous Forms
AUP - Acceptable Use Policy - Internet Access
Bloodborne Pathogen Policy
Computer Purchase Program 23-24
Extra Trip Request Form
Field Trip Policy/Forms (NEW) (PDF)
Field Trip Policy/Forms (NEW) (WORD)
HHS Overnight Trip Form
Mileage Reimbursement (eff. 1.1.2024)
Proof of Residency Form
Safety Handbook for Staff
Student Transfer Form
SUB Teacher Time Report
Tenure and RIF Processes
Transportation Request Form
Travel Request / Expense Report (2024)
Tuition Reimbursement Form and Info
Tutoring Reimbursement Form

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Technology Department
Accessing public folders/calendars using the web
Accessing public folders/calendars using Outlook
Connecting Android devices to e-mail server
Connecting iPads and iPhones to e-mail server
Connecting your personal laptop to school email using Microsoft Outlook
Google Apps for education sign in  
Link to Technology Help Desk
New online e-mail link
Setting up your web-page
Teacher Webpage Tutorial Video
Teacher/Staff request to your add personal device on wireless

Maintenance Request Forms
Activity and Facility Usage Request Form
BGS Maintenance Request Form
Custodial Request Form
Foods Maintenance Request Form
HHS Maintenance Request Form
HIS Maintenance Request Form
LMS North Maintenance Request Form
LMS South Maintenance Request Form
Special Services Maintenance Request Form
Technology Maintenance Request Form
Transportation Maintenance Request Form

Food Service Department

Lunch Count Form: https://forms.gle/ftGeXuEoi8BurxEeA