Welcome to Klein ISD
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- Kristian Howard
- 6 years ago
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1 Welcome to Klein ISD Congratulations and welcome to your new position at Klein ISD. As part of our hiring process, we ask that you follow the hiring steps listed below: 1. Read the Frequently Asked Questions Sheet. The FAQ sheet can be found under the Important Links section. 2. Download, print (single sided only) and bring with you the completed Part-Time New Hire Packet. The appropriate packet is attached to this Welcome page. You will also need to bring your unexpired driver s license and social security card. Your Human Resource Specialist will contact you soon to set up an appointment to complete the hiring process and answer any questions you may have. We wish you all the best!!!!
2 Instructions for Part-Time New Hire Staff Paperwork Information Requiring Action and Signatures The items following this instruction sheet will need to be downloaded, completed with required information and signed. All items in red must be brought with you on your signing day. Please print all forms single sided. TEA Staff Ethnicity and Race Questionnaire (Part l and Part 2) Make selection from Part 1 and Part 2 Sign, Date and add your Employee ID that was given to you by your HR Specialists. W-4 Form Complete bottom section of form, sign and date. We only need the 1 st page with your signature and not the worksheet. I-9 Form Fill in Section 1, sign and date Bring in your current Drivers License and Social Security Card on the day of your contract signing. Acceptable Documents are listed on page 3 of the I9 Form. Authorization Agreement for Direct Deposits- Bring this with you and you will take this to the payroll department on the day of signing. You will need your bank routing numbers Employee Acknowledgement of the Alliance Direct Contracting Program- Please review this information under Important Links. Complete, sign and date this page and bring with you. Pre-Employment Affidavit for Applicant Offered Employment Please complete Pre-Employment Affidavit form and bring with you for your HR Specialists to Notarize. NOTE: Open Records All personal information is kept confidential unless otherwise stated.
3 General Information This is general information you will want to keep for your records FICA Alternative Retirement Plan for Part-Time Employees NOT Covered by TRS Human Resources Employee List Drug Prevention Program Certification Policy Number C-10 Fraud Line Information Employee Access Center Preferred First Name Signing Day Information Your Payroll Specialist will call you for a signing appointment. At that time, you will be given your Employee ID. In addition to these completed forms, these items will be required or completed with your Payroll Specialist on your signing day: You must bring with you your current drivers license and Social Security Card. If required, bring with you your Original Official Transcript(s) with degrees posted. You will have your photo taken and receive your campus/department ID NOTE: All personal phone numbers and addresses are kept confidential unless otherwise requested.
4 . Other Important Information for New Employees Benefits Information: Part-Time Employees are defined as working on a regular basis: less than 20 hours per week or 0.49 or less FTE. Part-time employees are eligible to enroll in a TRS-ActiveCare medical plan; however, part-time employees are NOT eligible for the district contribution and will be required to pay the entire premium set by TRS. Part-time employees are NOT eligible to participate in any other benefits, except medical and the individual retirement plans, 403B and 457. Please review Benefits Information under Benefits Link. Enrollment Guide for Health Plans
5 KLEIN INDEPENDENT SCHOOL DISTRICT 7200 Spring Cypress Road, Klein, Texas Phone: Fax: Texas Education Agency Texas Public School Student/Staff Ethnicity and Race Data Questionnaire The United States Department of Education (USDE) requires all state and local education institutions to collect data on ethnicity and race for students and staff. This information is used for state and federal accountability reporting as well as for reporting to the Office of Civil Rights (OCR) and the Equal Employment Opportunity Commission (EEOC). School district staff and parents or guardians of students enrolling in school are requested to provide this information. If you decline to provide this information, please be aware that the USDE requires school districts to use observer identification as a last resort for collecting the data for federal reporting. Please answer both parts of the following questions on the student s or staff member s ethnicity and race. United States Federal Register (71 FR 44866) Part 1. Ethnicity: Is the person Hispanic/Latino? (Choose only one) Hispanic/Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Not Hispanic/Latino Part 2. Race: What is the person s race? (Choose one or more) American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains a tribal affiliation or community attachment. Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. Black or African American - A person having origins in any of the black racial groups of Africa. Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. Student/Staff Name (please print) Student/Staff Signature Student/Staff Identification Number Date Texas Education Agency March 2009 Revised: 10/27/2011
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7 You do not have to return this sheet with your packet.
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11 KLEIN INDEPENDENT SCHOOL DISTRICT AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT (CREDITS) SUBMITTING INSTRUCTIONS 1. Please sign form in any color, NO BLACK INK 2. Print out and bring this form to Klein Central Office Payroll Room # Bring check for verification of your bank routing # and your account # 4. For identity theft protection please DO NOT submit via inter-school mail, fax or . Forms received by these methods will not be processed. 5. Retain one copy for your records. NAME KLEIN ID/ # CHECK ONE: ADD NEW CHANGE EXISTING CANCEL CHANGE AMOUNT CHECK ONE: CHECKING SAVINGS Amount $ If no specific amount, write ALL. If change, enter new amount. BANK / DEPOSITORY NAME BANK ROUTING # ACCOUNT # Verified by payroll (First nine digits on bottom of check) Verified by payroll The KLEIN ISD is not responsible for overdraft charges that might result from an inactivated account. I hereby authorize KLEIN INDEPENDENT SCHOOL DISTRICT hereinafter to initiate credit entries and, if errors occur, authorize correcting entries to my ACCOUNT indicated below and the depositary name below to credit the same to such account credit entries or change amounts as stated above: SIGNATURE DATE OFFICE USE ONLY Bank Code # Ded Code # Checking Circle One Savings Bank Code # 578 Ded Code # 1501 Smart Financial Saving Date Entered: Entered By:
12 EMPLOYEE ACKNOWLEDGMENT OF THE ALLIANCE DIRECT CONTRACTING PROGRAM I have received information that tells me how to get health care under my employer s workers compensation coverage. If I am hurt on the job and live in a service area described in this information, I understand that: 1. I must choose a treating doctor from the Alliance list of doctors designated as treating doctors. 2. I must go to my treating doctor for all health care for my injury. If I need a specialist, my treating doctor will refer me. If I need emergency care, I may go to any licensed medical professional within the United States. 3. Even though my treating doctor should refer me to a specialist of providers contracted with the Alliance, I understand that I need to verify that the referral doctor is a member of the Alliance provider panel. 4. The Texas Association of School Boards Risk Management Fund will pay the treating doctor and other Alliance providers for all health care related to my compensable injury. 5. I may have to pay the bill if I receive health care from a provider other than an Alliance provider without prior approval from the Fund. 6. Making a false or fraudulent workers compensation claim is a crime that may result in fines and or imprisonment. 7. If I want to change doctors after my first choice, I can only choose from the Alliance list of providers. A third choice requires approval from my adjuster. / / Signature Date Printed Name I reside at: Street Address,, City State Zip Code Name of Employer: Klein ISD Name of Direct Contracting Program: Political Subdivision Workers Compensation Alliance (the Alliance) Direct contracting service areas are subject to change. To locate a treating doctor within your area, visit the PSWCA web site at or call your adjuster at To be completed by the employer only Please indicate whether this is the: Initial Employee Notification Injury Notification (Date of Injury: / / ) DO NOT RETURN THIS FORM TO THE TASB RISK MANAGEMENT FUND UNLESS REQUESTED.
13 EMPLOYEE ACKNOWLEDGMENT OF THE ALLIANCE DIRECT CONTRACTING PROGRAM RECONOCIMENTO DEL EMPLEADO PARA EL PROGRAMA DE CONTRATAR DIRECTAMENTE CON MEDICOS He recibido la información que explica como obtener tratamientos médicos si me lastimo en el trabajo. También entiendo si me lastimo en el trabajo: 1. Tengo que escoger un doctor de la lista de Alliance (PSWCAA), que son designados para tratar. 2. Tengo que ir al doctor escogido por mí para tratamiento relacionado a mi lastimadura. Si necesito un especialista, el doctor que escogí tiene que referir me a ese especialista. Si necesito tratamientos de emergencia, yo entiendo que puedo ir a cualesquier doctor licenciado en los Estados Unidos. 3. Si el doctor que escogí me refiere a un especialista, tengo que verificar que el especialista también es aprobado por la PSWCA. 4. La compañía TASB le pagara al doctor escogido por mí y a doctores también que son partidos de PSWCA. 5. Si voy a un doctor que no es aprobado por TASB, y no pertenece al partido de la PSWCA, y no he obtenido aprobación, entiendo que es posible que tendré que pagar esa cuenta. 6. Reportando un reclamo falso de lastimadura en el trabajo es un crimen que pueda resultar en multas o encarcelamiento. 7. Si deseo cambiar doctor después del primer doctor escogido, nada mas puedo escoger de la lista de doctores aprobados por PSWCA. Si deseo cambiar doctor por la tercera ves, tendré que recibir aprobación de mi ajustador de la compañía TASB, antes de cambiar. Signature (firma): Date (Fecha) Printed Name (Nombre en imprenta): Address (Dirección de domicilio incluyendo cuidad, estado y zip): Employer (Nombre de empleador): Klein ISD Nombre del programa de contratar doctores directamente: POLITICAL SUBDIVISION WORKERS COMPENSATION ALLIANCE (PSWCA) El servicio de contratar doctores directamente en las áreas de servicio, son subjetivos a cambiar. Para localizar un doctor de tratamiento en su área, visite al Internet en: o llame a su ajustador al numero: To be completed by the employer only (Para completar por el empleador solamente) Please Indicate whether this is the: Initial Employee Notification Injury Notification (Fecha de lastimadura ) DO NOT RETURN THIS FOR TO THE TASB RISK MANAGEMENT FUND UNLESS REQUESTED. (NO REGRESE ESTA FORMA A TASB SOLO QUE SEA REQUERIDA)
14 Pre-Employment Affidavit for Applicant Offered Employment For purposes of this affidavit: Adjudication and conviction refer to a conviction, plea of guilty or no contest (nolo contendre), probation, suspension, or deferred adjudication. Charge refers to a formal criminal charge as documented by a primary charging instrument (a complaint, information, or indictment) under the Texas Code of Criminal Procedure. Inappropriate relationship refers to the crime of improper relationship between educator and student in Texas Penal Code section 21.12, and any other inappropriate relationship as determined by the State Board for Educator Certification. I declare the following: o o o I have never been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor. I have been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor. The charge, adjudication, or conviction was determined to be false. The following are all of the relevant facts pertaining to the charge, adjudication, or conviction:. I have been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor. The charge, adjudication, or conviction was determined to be true. The following are all of the relevant facts pertaining to the charge, adjudication, or conviction:
15 Affidavit of Applicant Offered Employment The following affidavit is offered to satisfy the requirement of Texas Education Code section for a pre-employment affidavit. I declare under penalty of perjury that the foregoing is true and correct. Name (First, Middle, Last) Address (Street, City, State, Zip Code) Date of Birth County Executed in County, State of Texas, on the day of,. County Date Month Year (Signature of Declarant) State of Texas County of Before me, (insert the name of the notary), on this day personally appeared (insert the name of the applicant), known to me [or proved to me on the oath of or through (description of identity card or other document) to be the person whose name is subscribed to the foregoing instrument] and acknowledged to me that he executed the same for the purposes and consideration therein expressed. Given under my hand and seal of office this day of, (year). (Personalized Seal) Notary Public s Signature I understand that the date of birth I am providing will not be used to determine eligibility for employment but will be used solely for the purpose of this pre-employment affidavit. * *This form will be processed separately and not shared with the hiring manager. Approved by the Texas Commissioner of Education, October 2017.
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