Bloom-Carroll

Local School District

OUR STUDENTS • THEIR FUTURES • OUR FOCUS

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NEWS

SOCIAL

EVENTS

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Forms

Enrollment

Final Forms

Records Release

Food Service

Free and Reduced Lunch Application

Medical Forms

Student Accident Insurance Form

Asthma Action Plan Form

Diabetes Management Action Plan Form

Food Allergy Action Plan Form

Medication Authorization Form

Seizure Action Plan Form

High School Forms

ACT Opt Out Form

Guest Form

OSHAA Physical Form

Flexible Credit Application

College Visitation Form

Letter of Recommendation Request

Medication Authorization

Work Permit Application

Vacation Form

BCHS Graduation Workbook

Physical Education Waiver Form

CURRENT STUDENT Transcript Request Form

FORMER STUDENT Transcript Request Form

Middle School Forms

Vacation Form

Elementary School Forms

Counselor Referral Form

Vacation Form

Fiscal Services Forms

Activity Cash Transmittal Form

Building Cash Transmital Form

Credit Card Purchase Recap Form

Purchase Requisition Form

Budget Purpose Statement Form

Sales Project Potential Form

Payroll and Employee Benefit Contact Information

Please contact the Payroll and Benefits Department by emailing [email protected] for any payroll or insurance questions.

Employee Pay Request Forms

Professional Development Approval Form

Classroom Coverage Request for Payment

Extra Time Request for Payment

Mileage Reimbursement Request for Payment

Substitute Employee Request for Payment

Supplemental Contract Request for Payment

Tutor-Time Sheet Request for Payment

Employee Payroll Forms

2024-2025 Employee Pay Schedule

Unpaid Leave Request Form

Change of Address/Name Form

Direct Deposit Authorization Form

W4 Federal Withholding Form

Oh State Withholding Form

Employee Benefit Notices and Forms

FMLA Procedures

Introduction to Benefits

2024-2025 Insurance Rates

Insurance Enrollment Form

1.800MD

Health Benefit Plan

Summary of Benefits and Coverage Medical

Dental Benefit Plan Summary

Vision Benefits (VSP)

Additional Life Insurance Form

CareFactor Mobile App

Healthcare Bluebook

HIPPA Privacy Notice

Women's Health and Cancer Rights Act

Medicare Notice

Health Insurance Marketplace Coverage Options

MyEAP App

Employee Assistance Plan (EAP)

NSA Disclosure Form

Employee Professional Development Forms

Form 1-Employee Profile and IPDP

Form 2-Workshop Approval

Form 3A-College Coursework Approval

Form 3B-Tuition Reimbusement Request

Form 4A-PDU Pre-Approval

Form 4B-PDU Log

Form 5-IPDP Review

Reciprocity Form