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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 2023-2024 is closed.

Should you experience a qualifying life event, 
please contact Payroll/HR at 815-421-5016

Online Enrollment Guide

EBC MyCHoice Mobile App - NEW! 

23-24 Insurance Rates

EBC Summary for 2023-2024

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) 23.24
HSA Frequently Asked Questions
HSA PPO Handout
HSA Salary Reduction Agreement 2023

HRA PPO Summary of Benefits and Coverage (SBC) 23.24
HRA PPO Handout
HRA Deductible Reimbursement Form * Send w/ your EOB to the Unit Office Attn: H. Crane
Insurance Waiver 22-23
Insurance Waiver 23-24
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

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

Payroll/Human Resources Documents
2022-2023 Pay Dates
2023-2024 Pay Days
403b Meaningful Notice/Plan Information Brochure and Annual Retirement Benefits Guide 
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
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Application Signature Page
AUP Acceptable Use Policy 

Bookkeeping/Payroll Form Instructions
DCFS Mandated Reporter Acknowledgment 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

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 - updated 2-2023
Personnel Recommendation Form - WORD - updated 2-2023
Personnel Recommendation Form - PDF - - - USE AFTER JULY 1, 2023 

Personnel Recommendation Form - WORD - - - USE AFTER JULY 1, 2023 
Physical Exam Form
Standards and Procedures for Staff
Statement Concerning Employment in a Job Not Covered by Social Security

W-4 Illinois

W-4 Federal (2022)  - click here for more information 
        Questions about your federal withholding? Click here for some information


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