• 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
    HPS-L1
    Request for Leave or Approved Absence
    HPS-L2
    Advanced Leave Agreement
    HPS-L3
    FMLA Employee Form (Non-HTA)
    HPS-L4
    FMLA Employee Form (HTA)
    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
    BENEFIT FORMS
      Miscellaneous:
    HPS-B1
    Section 125 Cafeteria Plan Employee Waiver/Election & Compensation Reduction Agreement
    DHCFR-EHIRD11
    MA Health Insurance Responsibility Disclosure (HIRD) 2011
    TOH-B1
    Town of Hopkinton HIPAA Privacy Notice
    TOH-B2
    Town of Hopkinton HIPAA Privacy Acknowledgement
    HPS-B3
    Employee Assistance Program (EAP) Information
      Flexible Spending Accounts:
    HPS-B3
    Benefit Strategies Flex Spending Account Information
    BENST-1
    Benefit Strategies Flex Spending Account Reimbursement
    BENST-3
    Benefit Strategies Medical Flex Eligible Expenses
    BENST-2
    Benefit Strategies Flex Spending Account Enrollment '11-'12

    Health Insurance (Medical):
    TFT-1
    Tufts Enrollment/Change Form (use for all Tufts products)
    TFT-2
    Tufts HMO Premium Summary of Benefits
    TFT-3
    Tufts Advantage HMO Summary of Benefits
    TFT-HMO
    Tufts Advantage & Premium HMO General Benefit Information
    TFT-4
    Tufts Carelink PPO Summary of Benefits
    TFT-PPO
    Tufts Carelink PPO General Benefit Information
    TFT-5
    Tufts Health Care Fitness Reimbursement Form
    TFT-6
    Tufts Pharmacy Review Request Form

    Health Insurance (Dental):
    DEL-1 Delta Dental Enrollment/Change Form
    DEL-2 Delta Dental Premiere Voluntary Plan Information
    DEL-3 Delta Dental Premiere Voluntary Enhanced Plan Information
    ASRT-1 Assurant Dental Summary & Enrollment FY 12
      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
      Life Insurance:
    BOS-A Boston Mutual Voluntary Life Information
    BOS-1 Boston Mutual Life Evidence of Insurability Form
    BOS-2 Boston Mutual Authorization for Release
    BOS-3 Boston Mutual Life Enrollment/Declination Form
    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 Smart Plan Information Guide
    TOH-B3 Town of Hopkinton Retiree Exit Form (to elect retiree health benefits)
    CPI-0 403(b) Information Sheet
    CPI-1 403(b) Elective Deferral & Vendor Election Form
    CPI-2 Approved 403(b) Plan Vendor List
    CPI-3 CPI Participant Website Instructions-403(b)
    CPI-4 Request for a Contract Exchange-403(b)
    CPI-5 Request for a Loan Voucher-403(b)
    CPI-6 Request for a Hardship Withdrawl Voucher-403(b)
    CPI-7 Request for a Distribution-403(b)
    PROFESSIONAL DEVELOPMENT FORMS
    HPS-PD1 Request for Conference Attendance
    HP-PD Instructions Coursework Procedures Information Sheet
    HPS-PD2 Intent to Submit
    HPS-PD3 Course Approval
    HPS-PD4 Tuition Reimbursement and/or Course Credit Request
    HPS-PD5 Summer Curriculum Project Proposal
    HPS-PD6 Inservice Course Credit Award Program Guidelines
    HPS-PD7 Inservice Course Credit Approval
    HPS-PD8 Inservice Course Certificate of Successful Completion
    PERFORMANCE EVALUATION TEMPLATES
    HPS-EVALSS/AA Evaluation Form - Secretarial Support/Administrative Assistants
    HPS-EVALTA/SpEd Evaluation Form - Special Education Teaching Assistants
    HPS-EVALTA/GenEd Evaluation Form - General Education Teaching Assistants
    RECRUITING FORMS FOR ADMINISTRATORS
    HPS-R1 Request for Approval to Begin Hire
    HPS-R6 Interview Confidentiality Statement
    HPS-CR Candidate Interview Rating Sheet-Numerical Score Format
    HPS-CR1-LIK Candidate Interview Rating Sheet-Likert Scale Format
    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-REF1 Reference Check
    MISCELLANEOUS NEW HIRE FORMS
    FED-I9Y Employment Eligibility Verification (I-9)
    SSA-1945 Statement Concerning Your Employment in a Job Not Covered by Social Security
    SSA-0510045 Windfall Elimination Provision Fact Sheet
    SSA-0510007 Government Pension Offset Fact Sheet
    SSA-0510051 How State & Local Government Employees Are Covered by Social Security & Medicare
    HPS-NH1 District Property Inventory
    MA-EP Employment Permit Application for 14 through 17 year-olds
    PAYROLL FORMS
    MA-M4 MA Employee's Withholding Exemption Certificate (MA M-4)
    FED-W4 Employee's Withholding Allowance Certificate (Federal W-4)
    HPS-TA1 Non-Exempt & Contingent Employee's Time Sheet
    HPS-P1 Direct Deposit Request
    HPS-CURR Time Sheet for Curriculum Work Submission
    MISCELLANEOUS FORMS
    HPS-M1 Employee's Request for Reasonable Accommodation
    HPS-EH Employee Handbook 2011-2012
    HPS-EHA Employee Handbook Acknowledgement Form-Understanding by Employee
    TOH-M1 Town of Hopkinton Hold Harmless for Volunteers
    HPS-IR Incident Report
    HPS-SIA Student Injury/Accident Report
    HPS-EIR Employee Personal Injury Report
    HPS-EX1 Mileage & Expenses Reimbursement Request (non-HTA)
    MA-ETH Summary of the Conflict of Interest Law for Municipal Employees
    SUBSTITUTE PACKET FOR ADMINISTRATORS
    SUB-1 Substitute Teacher/Nurse Packet Instructions
    SUB-2 Substitute Teacher Application
    SUBN-2 Substitute Nurse Application
    SUB-3 Substitute Interview Rating Form
    SUB PAY Substitute Pay Rate Information
    OBRA-1 OBRA (Mandatory Deferred Comp Plan) Information Sheet
    OBRA-2 OBRA Acknowledgement Card
    OBRA-3 OBRA Smart Plan Information Guide
    SSA-1945 Statement Concerning Your Employment in a Job Not Covered by Social Security
    FED-I9Y Employment Eligibility Verification (I-9)
    FED-W4 Employee's Withholding Allowance Certificate (Federal W-4)
    MA-M4 MA Employee's Withholding Exemption Certificate (MA M-4)
    SUB-3 Substitute Teacher Job Description
    HANDBK Substitute Handbook
    HDBK-ACK Understanding by Substitute (Handbook Acknowledgement)
    MA-ETH Summary of the Conflict of Interest Law for Municipal Employees
    VOLUNTEER PACKET (for those volunteering in the schools)
    CORI-SUB CORI Application for Volunteers
    CON-INT Summary of Conflict of Interest Law
    HOLD-HARMLESS Hold Harmless for Volunteers