​​​​Attendance Forms:

     Request To Adjust Personal Day Bank
Personal Day Request Form
Cancer Screening Verification Form

     Reason For Absence (To Be Completed By Employee) Form

Annual Turn-in of Unused Sick Days Group C:

​     Long Beach School Employees’ Association– Group C Form

     Request for Payment in Exchange for Vacation Days

     Request for Payment for Unused Sick Days - Transportation Only
Request For Carryover Of Vacation Days Form
     Vacation Day Payment Form Choices –
Confidential Employees Only

     Vacation Day Payment – At Separation from LBCSD ONLY

Benefits Forms:

     EMPIRE Young Adult Option - Medical
     Flexible Spending Accounts
Leave of Absence Direct Pay
Life/AD&D/EMM Enrollment/Change Form
Open Enrollment (Health)
Reasonable/Workplace Accommodations

     Summaries of Medical and Dental Benefits
Surviving Spouse/Dependent Election Form

Claim Forms:

     Dental Claim Form

     Empire Health Insurance Claim Form
Excess Major Medical Form  
Eyeglass Reimbursement Claim Form
Flex Voucher 
Worker's Compensation - POMCO

HR Forms:
Mandatory Annual Training and Staff Handbook
Maternity Leave of Absence Request Form
Overtime Request and Authorization


     Scholarship Application Form 2017  NEW

     Conference Reimbursement Form

Misc. Forms:
Direct Deposit Form and Direct Deposit Q&A
ERS Beneficiary Form
TRS Change of Beneficiary Form

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