• Commonly used employee forms appear below for your convenience. Many are screen-fillable. Please click on the form number to access the form. Please be aware that not all forms are applicable to all employees.

    Please scroll down to view the complete list. If you have any questions, contact the Director of Human Resources for assistance.

    LEAVE FORMS
     
     DOL-WH380E  FMLA Health Care Provider Form-Employee's Own Health Condition
     DOL-WH380F  FMLA Health Care Provider Form-Family Member's Health Condition
     DOL-WH384  FMLA Military Leave-Qualifying Exigency
     DOL-WH385  FMLA Military Leave-Covered Service Member's Health Condition
     HPS-L1  Request for Leave or Approved Absence - Screen Fillable Form
     HPS-L1.5  Request for Leave or Approved Absence - Manually Fillable Form
     HPS-L2  Advanced Leave Agreement
     HPS-L3  FMLA Employee Form (Non-HTA)
     HPS-L4  FMLA Employee Form (HTA)

    BENEFIT FORMS -  Miscellaneous
     
     HPS-B1  Section 125 Cafeteria Plan Employee Waiver/Election & Compensation Reduction Agreement
     HPS-B3  Employee Assistance Program (EAP) Information
     HPS-B4  FY 18 Health & Basic Life Insurance Rate Chart
     OMB 1210-0149  Health Insurance Marketplace Coverage Notice
     TOH-B1  Town of Hopkinton HIPAA Privacy Notice
     TOH-B2  Town of Hopkinton HIPAA Privacy Acknowledgement

    BENEFIT FORMS -  Flexible Spending Accounts
     HRC-1  Flex Spending (Health and/or Dependent Care) Enrollment Form
     HRC-2  Flexible Spending General Information
     HRC-3  Flexible Spending Claim Form

    BENEFIT FORMS -  Health Insurance (Medical)
     BCBS-1  BCBS Enrollment and Change Form Med-Dent
     BCBS-2  BCBS HMO Blue New England Value+ Plan Summary
     BCBS-3  BCBS HMO Blue New England Deductible Plan Summary
     BCBS-4  BCBS PPO Blue Care Elect Value+ Plan Summary
     BCBS-5  BCBS Dental Blue LOW
     BCBS-6  BCBS Dental Blue HIGH
     BCBS-7  BCBS Dental Rollover Information
     BCBS-8  BCBS Fitness Reimbursement Form
     BCBS-9  BCBS Weight Loss Reimbursement Form
     HPS-B4  FY 18 Health & Basic Life Insurance Rate Chart
    BENEFIT FORMS -  Long-Term Disability Insurance
     SL-1  Sun Life Long-Term Disability Enrollment Form
     SL-2  Sun Life Long-Term Disability Claim Form
     SL-3  Sun Life Long-Term Disability Evidence of Insurability Form
     SL-4  Sun Life Long-Term Disability Program Outline
    BENEFIT FORMS -  Life Insurance
     BOS-1  Boston Mutual Life Evidence of Insurability Form
     BOS-2  Boston Mutual Authorization for Release
     BOS-3  Boston Mutual Life Enrollment/Declination Form
     BOS-A  Boston Mutual Voluntary Life Information
    RETIREMENT PLAN FORMS
     MCR-1  Middlesex County Retirement Board Enrollment Form
     OBRA-1  OBRA (Mandatory Deferred Comp Plan) Information Sheet
     OBRA-2  OBRA Acknowledgement Card
     OBRA-3  OBRA Withdrawal Form and Instructions
     OMNI-1  403(b) Information Sheet and Salary Reduction Form
     OMNI-2  Approved 403b Plan Vendor List
     OMNI-3  OMNI 403b Participant Website Instructions
     OMNI-4  403b Loan Withdrawal Form
     OMNI-5  403b Hardship Withdrawal Form
     OMNI-6  OMNI 457 Salary Reduction Form
     R000-RCEI  MTRS Enrollment Assignment Sheet
     TOH-B3  Town of Hopkinton Retiree Exit Form (to elect retiree health benefits)
    PROFESSIONAL DEVELOPMENT FORMS
     HP-PD Instructions  Coursework Procedures Information Sheet Teachers
     HPS-PD1  Request for Conference Attendance
     HPS-PD2  Intent to Submit Teachers
     HPS-PD3  Course Approval Teachers
     HPS-PD3F  Course Approval Form Food Service Workers
     HPS-PD3P  Course Approval Form Paraprofessionals
     HPS-PD4  Tuition Reimbursement and/or Course Credit Request Teachers
     HPS-PD4F  Course Reimbursement Request Food Service Workers
     HPS-PD4P  Course Reimbursement Request Paraprofessionals
     HPS-PD6  Inservice Course Credit Award Program Guidelines Teachers
     HPS-PD7  Inservice Course Credit Approval Teachers
     HPS-PD8  Inservice Course Certificate of Successful Completion Teachers
    PERFORMANCE EVALUATION TEMPLATES
     HPS-EVALSS/AA  Evaluation Form - Secretarial Support/Administrative Assistants
     HPS-EVALTA/GenEd  Evaluation Form - General Education Teaching Assistants
     HPS-EVALTA/Library  Evaluation Form - Library Assistants
     HPS-EVALTA/SpEd  Evaluation Form - Special Education Teaching Assistants
    RECRUITING FORMS FOR ADMINISTRATORS
     HPS-CR  Candidate Interview Rating Sheet-Numerical Score Format
     HPS-CR1-LIK  Candidate Interview Rating Sheet-Likert Scale Format
     HPS-R1  Request for Approval to Begin Hire
     HPS-R2  Highly Qualified Teacher Checklist
     HPS-R3  Highly Qualified Teacher Status Certificate
     HPS-R4  Recommendation to Hire
     HPS-R5  Release & Waiver of Confidentiality
     HPS-R6  Interview Confidentiality Statement
     HPS-REF1  Reference Check
    MISCELLANEOUS NEW HIRE FORMS
     BC-1  Background Check: How To Register for Fingerprinting
     BC-2  SAFIS Fingerprinting Registration Guide
     BC-3  Acceptable Forms of ID for Fingerprinting Appointment
     FED-I9Y  Employment Eligibility Verification (I-9)
     GCN-1  Global Compliance Network (GCN) Training User Instructions
     MA-EP  Employment Permit Application for 14 through 17 year-olds
     SSA-0510007  Government Pension Offset Fact Sheet
     SSA-0510045  Windfall Elimination Provision Fact Sheet
     SSA-0510051  How State & Local Government Employees Are Covered by Social Security & Medicare
     SSA-1945  Statement Concerning Your Employment in a Job Not Covered by Social Security
    PAYROLL FORMS
     FED-W4  Employee's Withholding Allowance Certificate (Federal W-4)
     HPS-P1  Direct Deposit Request
     HPS-P2  Direct Deposit E-Mail Authorization
     HPS-PYDT  FY 18 Pay Date Schedule
     HPS-TA1  Non-Exempt & Contingent Employee's Time Sheet
     HPS-XPAY  Extra Work Presented for Payment Form
     MA-M4  MA Employee's Withholding Exemption Certificate (MA M-4)
    MISCELLANEOUS FORMS
     HPS EH  Employee Handbook
     HPS-EHA  Employee Handbook Acknowledgement Form-Understanding by Employee
     HPS-EIR  Employee Personal Injury Report
     HPS-EX1  Mileage & Expenses Reimbursement Request (non-HTA)
     HPS-GBEBC  Employee Disclosure of Gifts
     HPS-M1  Employee's Request for Reasonable Accommodation
     MA-ETH  Summary of the Conflict of Interest Law for Municipal Employees
     MA-ETHACK  Employee Acknowledgement-Summary of Conflict of Interest Law
     TOH-M1  Town of Hopkinton Hold Harmless for Volunteers
    SUBSTITUTE PACKET FOR ADMINISTRATORS
     FED-I9Y  Employment Eligibility Verification (I-9)
     FED-W4  Employee's Withholding Allowance Certificate (Federal W-4)
     HANDBK  Substitute Handbook
     HDBK-ACK  Understanding by Substitute (Handbook Acknowledgement)
     MA-ETH  Summary of the Conflict of Interest Law for Municipal Employees
     MA-M4  MA Employee's Withholding Exemption Certificate (MA M-4)
     OBRA-1  OBRA (Mandatory Deferred Comp Plan) Information Sheet
     OBRA-2  OBRA Acknowledgement Card
     OMB 1210-0149  Health Insurance Marketplace Coverage Options Notice
     SSA-1945  Statement Concerning Your Employment in a Job Not Covered by Social Security
     SUB PAY  Substitute Pay Rate Information
     SUB-1  Substitute Teacher/Nurse Packet Instructions
     SUB-2  Substitute Teacher Application
     SUB-3  Substitute Interview Rating Form
     SUB-3  Substitute Teacher Job Description
     SUBN-2  Substitute Nurse Application