| ADA Medical Inquiry Form |
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Have your medical provider complete the form and submit to EEO@MATSUK12.US . |
| ADA Request for Accommodations |
Complete this form to request accommodations under the American Disability Act (ADA). |
Complete the form and electronically sign through Adobe Sign. |
| Additional Time Worked |
Additional time worked by CEA employees that was not entered in Time & Attendance by the Payroll deadline should be submitted using this form. |
Submit the completed form to the Payroll Department. |
| Admin Secretary Payroll Calendar |
Payroll deadlines and important dates. |
For use by Admin. Secretaries. |
| Adult Worker Application |
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| Adult Worker Pay Calculation |
This form should be completed when paying adult workers with student activity funds. |
Submit the completed form to the Human Resources Department. |
| Amended Absences |
Absences entered in Absence Management that were not entered/corrected by the Payroll deadline should be submitted using this form. |
Submit the completed form to the Payroll Department. |
| Appreciation Payment |
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Building Substitute Form
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| Cell Phone Allowance |
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| Cell Phone Request |
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| Certified Adult Worker Application |
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| Co-Curricular Application |
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| Co-Curricular Reactivation |
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| Co-Curricular Stipend Request |
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| Column Move/Credit Count |
This Service Request is for MSEA employees to request a change in contract salary on the basis of additional credits earned OR to request that HR provide a course unit report (credit count). |
1) Request Official Transcripts
2) Fill out Request form and submit. Additional instructions and deadlines are on the Service Request page.
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Community Feedback Survey
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| COVID Leave Request FY22 |
MSEA Covid leave request form for 1st semester of FY22 |
Submit to Payroll Department |
| Dependent Day Care Reimbursement |
American Fidelity Dependent Day Care reimbursement request. |
Submit the completed form to American Fidelity |
| Employee Submitted Expense Adjustment |
This form is for notifying the Payroll Department that an expense claim was incorrectly submitted. |
Submit the completed form to the Payroll Department |
| Fingerprint Form |
This form should be completed after scheduling a fingerprint appointment with the Human Resources department. |
Complete the form and electronically sign through Adobe Sign. |
| FMLA Application - Bonding |
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| FMLA Application - Employee's Serious Health Condition |
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| FMLA Application - Family Member's Serious Health Condition |
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| Health Insurance Address Change Form |
This form should be completed to update a employees' address with the Public Education Health Trust. |
Complete the form and electronically sign through Adobe Sign. |
| Health Insurance Claim Form |
This form can be used for medical, dental, vision and prescription claims if a health provider is not submitting a claim. |
Mail or fax the completed form to EBMS. |
| Health Insurance Dependent Update/Name Change |
This form should be used to add or remove dependents from an employees' health insurance plan |
Complete the form and electronically sign through Adobe Sign. |
| Health Insurance Pre-Tax Election |
You can elect or waive the option to have health insurance premiums withheld on a pre-tax basis by completing this form. |
Complete the form and electronically sign through Adobe Sign. |
| I-9 |
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Long Term Certified Substitute Form
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| MLMA Education/Certificate Stipend Request Form |
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Complete the form and electronically sign through Adobe Sign. |
| MSBSD UA College Savings Plan Payroll Deduction |
Use this MSBSD form to initiate or modify payroll deduction contributions to the University of Alaska College Savings Plan. |
Submit the completed form to the Payroll Department. |
| Pay Option Form |
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| Physical Exam Form |
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| PTO Leave Cash In Form |
MSEA, MSPA, MLMA, and EXEC employees should use this form to request to cash-in paid time off leave. |
Complete the form and electronically sign through Adobe Sign. |
| Request for Advancement on Salary Scale |
Please see Column Move/Credit Count Request on this table. |
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| Return to Work Authorization |
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| Section 125 Flexible Benefit Plan Expense Reimbursement Voucher |
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| Sick Leave Bank - Certified Application |
This is the sick leave bank application for MSEA and MSPA employees that are members of the bank. |
Submit the completed application to the Sick Leave Bank Chairperson |
| Sick Leave Bank - Certified Special Collections Application |
This is the special collections sick leave bank application for MSEA and MSPA employees that are members of the bank |
Submit the completed application to the Sick Leave Bank Chairperson. |
| Sick Leave Bank - Classified Application |
This is the sick leave bank application for CEA employees that are members of the bank. |
Submit the completed application to the Sick Leave Bank at matsuceaslb@gmail.com |
| Sick Leave Bank - Classified Special Collections Applications |
This is the special collections sick leave bank application for CEA employees that are members of the bank |
Submit the completed application to the Sick Leave Bank at matsuceaslb@gmail.com |
| Sick Leave Bank Notification - Certified |
Certified employees can elect to opt in or opt out of the Sick Leave Bank using this form. |
Submit the completed form to the Payroll Department |
| Sick Leave Bank Notification - Classified |
CEA employees can elect to opt in or opt out of the Sick Leave Bank using this form. |
Submit the completed form to the Payroll Department |
| Site Exclusion Form |
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| Special Pay Form |
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| Student Worker Pay Calculation |
This form should be completed when paying student workers with student activity funds. |
Submit the completed form to the Human Resources Department |
| Substitute-Temporary Worker Time Sheet |
This is an optional timesheet that schools and departments may utilize for internally reporting substitute/temporary worker time worked |
Submit the completed form to the Payroll Department. |
| Summer Pay Election Form |
CEA employees can elect to have money held back on each paycheck and paid in one lump sum on their last paycheck. |
Submit the completed form to the Payroll Department. |
| UA College Savings Plan Employee Payroll Deduction |
Use this form to initiate or change existing allocations of payroll deduction contributions to the University of Alaska College Savings Plan. |
Submit the completed form to the Payroll Department |
| Verification of Service |
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