EMPLOYEE'S WITHOLDING CERTIFICATE

Employee Withholding Certificate (Federal Withholding)

2023 Form W-4 (irs.gov)

MISSISSIPPI EMPLOYEE'S WITHOLDING EXEMPTION CERTIFICATE

State Withholding

MS Employee's Withholding Exemption Certificate.pdf (uscourts.gov)

EMPLOYMENT ELIGIBILITY VERIFICATION

I-9 Form Sheet 1

USCIS Form I-9

PERS of MISSISSIPPI

1. PERS of MISSISSIPPI

Membership Application – Full-Time Employment

Microsoft Word - Form 1, Membership Application.doc (ms.gov)

PERS of MISSISSIPPI

Beneficiary Designation – Full-Time Employment

Form 1B: Beneficiary Designation (ms.gov)

2. PERS of MISSISSIPPI

Non-Covered Employment Acknowledgment – Substitute/Part-Time Employment

Microsoft Word - Form 4A, Non-Covered Employment Acknowledgment.doc (ms.gov)

3. PERS of Mississippi

Reemployment of PERS Service Retiree Certification/Acknowledgement

PUBLIC EMPLOYEES’ RETIREMENT SYSTEM (ms.gov)

DIRECT DEPOSIT AUTHORIZATION

I acknowledge that I have received a copy of the job description and Mississippi Educator Code of Ethics. I agree to abide by all policies and procedures.

ACKNOWLEDGEMENT SHEET FOR RECEIVING EMPLOYEE HANDBOOK

This form is to be completed by each employee of the Greenville Public School District and kept on file by the Human Resources Department in the employee's personnel file.

I acknowledge that I have received a copy of the district's Employee Handbook. I agree to abide by all policies and procedures outlined in the booklet and I understand that this is a working document and there will be a need to revise policy when necessary.

ACKNOWLEDGEMENT OF CONDITIONAL EMPLOYMENT CONTRACT

Please read the following and complete the questions below:

I, ____________________________, an applicant for the position of ____________________________ with Greenville Public School District, having been recommended for employment in said position, hereby acknowledge that the foregoing Employment Contract is a conditional contract, and that the validity of said contract is conditioned upon the results of the criminal background check which I understand will be conducted. Accordingly, if any disqualifying information is received from the criminal background check, said contract shall be void and I will be dismissed from the aforesaid position of employment immediately without the necessity of any further action of the Superintendent or the Board of Trustees of the District.

I further understand that the only recourse I have in such events is the right to request an appearance before the Board to offer mitigating circumstances that may justify my continued employment, but the Board reserves the right to grant or reject my request at its sole discretion. I understand and agree that the final decision regarding my continued employment is reserved unto the Board, and its decision is not appealable to any other administrative body, court of law or equity or otherwise.

Acknowledge, stipulated and agreed to this ____ day of ________________, 202__.

NEW HIRE TRAINING INSTRUCTIONS

Dear Employee:

All employees within the Greenville Public School District must complete a suicide prevention training, Family Educational Rights and Privacy Act training, and a mental health training course as mandated by the Mississippi Department of Education. These trainings must be completed prior to your effective start date of employment with the district. Your certificates of completion will provide proof that you have completed these trainings and they must be turned in to the Department of Human Resources. Failure to do so will hinder your effective starting date of employment with the district.

If I can assist further in any way, please do not hesitate to contact the Human Resources Department at (662) 334-7005.

Sincerely,

Janet McDavid-Collins

Director of Human Resources

SUICIDE PREVENTION TRAINING

You can find this suicide prevention training at the following link:

https://jasonfoundation.com

1. Click on the Training module

2. Scroll down midway the screen and click on "Register/Login".

3. Enter your email address.

4. Click on "Register" to create an account. New employees must complete the 2-hour

training course entitled Youth Suicide: A Silent Epidemic" (Module 5).

5. Submit a copy of your certificate of completion to Human Resources Department below.

FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT

(FERPA) TRAINING

It is mandated by the State Department that all employees complete the Family Educational Rights and Privacy Act (FERPA) training. The link to access this required training can be found at:

https://studentprivacy.ed.gov/content/online-training-modules

1. Click on the training course entitled FERPA 101: for Local Education Agencies
2. Click on "Click here to access this course" or "FERPA 101: for Local Education Agencies"
3. Click on "Register" at the bottom left of the screen to create an account.
4. At the conclusion of the training you will receive a certificate of completion. Submit a copy of your certificate of completion to Human Resources Department below.

MENTAL HEALTH TRAINING

The mental health training can be found at:

https://www.classroomwise.org/

Once you access the link, proceed to do the following:

1. You will need to create an account.
2. Click Launch Course.
3. Click Classroom Well-Being Information and Strategies for Educators (View Description and Enroll).
4. Complete the training.
5. Print or copy your training certificate.
6. Turn in your certificate of completion into the Human Resources Department below.

REEMPLOYMENT OF PERS SERVICE RETIREE CERTIFICATION/ACKNOWLEDGEMENT

NON-COVERED EMPLOYMENT ACKNOWLEDGEMENT

STATE OF MISSISSIPPI

STATE AND SCHOOL EMPLOYEES' HEALTH INSURANCE PLAN

APPLICATION FOR COVERAGE

STATE AND SCHOOL EMPLOYEES' LIFE INSURANCE PLAN

ENROLLMENT/CHANGE REQUEST FORM

BENEFICIARY DESIGNATION

INSURANCE APPLICATION

DELTA DENTAL INSURANCE COMPANY

ENROLLMENT/CHANGE FORM

VISION INSURANCE

BENEFIT ELECTION/CONFIRMATION ENROLLMENT FORM AND INTEREST FORM

EMPLOYEE 403(B) PLAN ELIGIBILITY NOTICE

NEW EMPLOYEE / ORIENTATION PACKET

I certify that the above items have been discussed with me or provided to the Human Resources Department.