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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).

EBC Summary for 2022-2023

OPEN ENROLLMENT for 2022-2023 is now closed!
Online Enrollment Guide

New Employee? Got Insurance Questions?
Contact Crissy Livingston in Payroll at 815-421-5016 or via

22-23 Insurance Rates

Employer Cost & Participation Information (IMRF)


BCBS Dental Benefits -
LOW Plan
BCBS Dental Benefits - HIGH Plan

HSA PPO Summary of Benefits and Coverage (SBC)
HSA Frequently Asked Questions
HSA PPO Handout
HSA Salary Reduction Agreement 2023

HRA PPO Summary of Benefits and Coverage (SBC)
HRA PPO Handout
HRA Deductible Reimbursement Form * Send w/ your EOBs to UO Attn: C Livingston
Insurance Waiver 22-23
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 2022


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

Payroll/Human Resources DocumentsInserted Image
2022-2023 Pay Dates
403b Plan Summary Information
403b - 457b Plan Participation Guide

403b Enrollment/Change Form
403b (ROTH) Enrollment/Change Form

403b Investment Website
409-A Annualized Compensation Form (CERT)
457b Enrollment/Change Form
Application Signature Page
AUP Acceptable Use Policy 

Bookkeeping/Payroll Form Instructions
DCFS Mandated Reporter Acknowledgement Form 

Direct Deposit Form/Instructions
Drug and Alcohol-Free Workplace. Board Policy 5:50
Employee Information Form - Use to update personal information with UO
Employee - First Report of Injury Form/Instructions 
Extra Pay Sheet (CERT) Music Dept
Extra Pay Sheet (CERT) Not Music Dept
Extra Pay Sheet (NON-CERT)
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 4/2020
IMRF Voluntary Additional Contribution Make/Change Form
Personal Day Request Form

Personnel Recommendation Form - PDF - updated 7-2021
Personnel Recommendation Form - WORD - updated 7-2021
Physical Exam Form
Standards and Procedures for Staff
Statement Concerning Employment in a Job Not Covered by Social Security

W-4 Federal (2022)  
W-4 Illinois

Contract Links
PERA Overview  
PERA Public Acts  


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Mileage Reimbursement (eff. 1.1.2023)

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
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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