Useful Documents and Forms:
Personnel Information - For name changes submit this form with a copy of your social security card with your new name.
Change of Address - All address changes must be submitted through the Employee Self Service Portal.
School Experience Verification Form
Direct Deposit Enrollment - All direct deposit changes must be requested through the Employee Self Service Portal.
Form G-4 - Employee's Withholding Allowance for Georgia State Income Tax.
Form W-4 - Employee's Withholding Allowance for Federal Income Tax. Click here to access the IRS Withholding Calculator.
YMCA Membership Application
Factor X Fitness Membership Application
Factor X Fitness Cancellation Form
Backpack Buddies Enrollment Form
Family & Medical Leave
The following forms are required when requesting Family & Medical Leave. Please return them to Andrea Fletcher in the Finance Department. If you have short or long-term disability coverage, additional forms are required.
Request for Family & Medical Leave
Physician's Confirmation of Serious Health Condition
Maternity Leave
The following forms are required when requesting maternity leave. Please return them to Andrea Fletcher in the Finance Department. If you have short-term disability coverage, additional forms are required.
Request for Maternity Leave
Request for Family & Medical Leave
Physician's Confirmation of Pregnancy
Physician's Statement Following Pregnancy
Sick Leave Bank
The Sick Leave Bank (SLB) has been established to provide additional sick leave to members whose personal sick leave and other available leave has been exhausted and who are unable to perform their assigned duties for an extended period of time due to their own catastrophic illness or the catastrophic illness of their child, spouse, or parent. Employees must be a member of the SLB to be eligible to participate. You can review the Sick Leave Bank Guidelines at this link.
Andrea Fletcher
Employee Benefits Coordinator
Ph (229) 584-9120
Fax (229) 225-5233
afletcher@tcjackets.net