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Welcome to Klein ISD

Congratulations and welcome to your new position at Klein ISD. As part of our hiring process, we ask that you follow the hiring steps listed below:

1. If your position requires certification and you are not already holding a current certificate, please review the information listed under the “Certification” section on the New Hire Packet web page.

2. Read the “Frequently Asked Questions Sheet”. The FAQ sheet can be found under the “Important Links” section.

3. Download, print (single sided only) and bring with you the completed

“Professional/Teacher New Hire Packet”. The appropriate packet is attached to this Welcome page. You will also need to bring your unexpired drivers license and social security card.

Your Human Resource Specialist will contact you soon to set up an appointment to complete the hiring process and answer any questions you may have. We wish you all the best!!!!

Instructions for New Hire Professional/Teacher Paperwork

Information Requiring Action and Signatures The items following this instruction sheet will need to be downloaded, completed with required information and signed. All forms in red must be brought with you on your contract signing day. Please print all forms single sided.

• TEA Staff Ethnicity and Race Questionnaire (Part l and Part 2) – Make selection from Part 1 and Part 2 Sign, Date and add your Employee ID that was given to you by your HR Specialists.

• W-4 Form – Complete bottom section of form, sign and date. We only need the 1st page with your signature and not the worksheet.

• Statement Concerning Your Employment in a Job Not Covered by Social Security

Fill in information at top (Name and Social Security Number) Sign and Date both copies

• I-9 Form –

Fill in Section 1, sign and date Bring in your current Drivers License and Social Security Card on the day of your contract signing. Acceptable Documents are listed on page 3 of the I9 Form

• ESL Requirement Form – This information covers the ESL requirements for all teachers. Review all ESL Requirements under “Important Links”. The ESL Requirements were acknowledge and agreed upon on your Letter of Intent.

• Bilingual Requirements –

This section is for Bilingual Teachers and Bilingual Support Staff ONLY. Go to the Bilingual Requirements Section under “Important Links” and complete the appropriate Bilingual Forms and bring with you on signing day. You will also see the Bilingual Professional Development schedule under this link.

• Authorization Agreement for Direct Deposits- Bring this with you and you will take this to the payroll department on the day of contract signing. You will need your bank routing numbers

• Employee Acknowledgement of the Alliance Direct Contracting Program – Please review this information under “Important Links”. Complete, sign and date this page and bring with you.

• Acknowledgement of Receipt of Benefits Information – Complete, sign and date this form and bring it with you on signing day.

• Pre-Employment Affidavit for Applicant Offered Employment – Please complete Pre-Employment Affidavit form and bring with you for your HR Specialists to Notarize.

• NOTE: Open Records – All personal information is kept confidential unless otherwise stated.

Important Links These are links that may require action. Please review all links.

• Requirements and Responsibilities for Teachers • New Instructional Employee Orientation • Bilingual Teacher/Support Staff • ESL Requirements • Acknowledgement of Alliance

General Information Links These are links to general information for new hires. Please review all links.

• Human Resource Department Distribution List • Drug Prevention Program Certification • Policy Number C-10 • Fraud Line Information • Employee Access Center – Preferred First Name • FICA Alternative Retirement Plan for Part-Time Employees • FAQ

Contract Signing Day Information Your HR Specialist will call you for a signing appointment. At that time, you will be given your Employee ID. In addition to these completed forms, these items will be required or completed with your HR Specialist on your signing day:

• You must bring with you your current drivers license and Social Security Card. • Bring with you your Original Official Transcript(s) with degrees posted and

Original Services Records if you have received them from your previous employer. If you have requested these, please let your HR Specialist know at the time of signing.

• You will sign your Letter of Intent, Contract and turn in all signed New Hire Packet documents.

• You will have your photo taken and receive your school/department ID Badge.

• NOTE: All personal phone numbers and addresses are kept confidential unless

otherwise requested.

Other Important Information for New Employees

Required New Teacher Orientation Information: Please review the New Teacher Information and the New Teacher Orientation Schedule found under the “Important Links” section. This information applies to new teachers to the profession as well as new teachers to the district. Benefits Information: It is important that you review all Benefits Information on the New Hire Web Page “Benefits” link

• Enrollment Guide for Health Plans • Klein ISD Benefits Plan Information Booklet • Notice of Privacy Practices (HIPPA) • NOTICE – Federal Affordable Care Act • NOTICE – Federal Continuation of Coverage under COBRA • NOTICE – KISD Workers’ Compensation Insurance • Available Individual Retirement Plans • Required Deduction for Medicare

REMEMBER: The Benefits meeting is required.

KLEIN INDEPENDENT SCHOOL DISTRICT 7200 Spring Cypress Road, Klein, Texas 77379

Phone: 832.249.4218 Fax: 832.249.4018

Revised: 10/27/2011

Texas Education Agency

Texas Public School Student/Staff Ethnicity and Race Data Questionnaire

The United States Department of Education (USDE) requires all state and local education institutions to collect data on ethnicity and race for students and staff. This information is used for state and federal accountability reporting as well as for reporting to the Office of Civil Rights (OCR) and the Equal Employment Opportunity Commission (EEOC). School district staff and parents or guardians of students enrolling in school are requested to provide this information. If you decline to provide this information, please be aware that the USDE requires school districts to use observer identification as a last resort for collecting the data for federal reporting. Please answer both parts of the following questions on the student’s or staff member’s ethnicity and race. United States Federal Register (71 FR 44866) Part 1. Ethnicity: Is the person Hispanic/Latino? (Choose only one)

Hispanic/Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

Not Hispanic/Latino Part 2. Race: What is the person’s race? (Choose one or more)

American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains a tribal affiliation or community attachment.

Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black or African American - A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

________________________________ Student/Staff Name (please print)

________________________________ Student/Staff Signature

________________________________ Student/Staff Identification Number

________________________________ Date

Texas Education Agency – March 2009

KLEIN INDEPENDENT SCHOOL DISTRICT 7200 Spring Cypress Road, Klein, Texas 77379

Phone: 832.249.4218 Fax: 832.249.4018

Statement Concerning Your Employment in a Job Not Covered by Social Security

____________________________________________ ___________________________________ Employee Name Social Security Number Klein Independent School District_______ 74-6002337_____________ Employer Name Employer ID# Your earnings from this job are not covered under Social Security. When you retire, or if you become disabled, you may receive a pension based on earnings from this job. If you do, and you are also entitled to a benefit from Social Security based on either your own work or the work of your husband or wife, or former husband or wife, your pension may affect the amount of the Social Security benefit you receive. Your Medicare benefits, however, will not be affected. Under the Social Security law, there are two ways your Social Security benefit amount may be affected. Windfall Elimination Provision Under the Windfall Elimination Provision, your Social Security retirement or disability benefit is figure using a modified formula when you are also entitled to a pension from a job where you did not pay Social Security tax. As a result, you will receive a lower Social Security benefit than if you were not entitled to a pension from this job. For example, if you are age 62 in 2005, the maximum monthly reduction in your Social Security benefit as a result of this provision is $313.50. This amount is updated annually. This provision reduces, but does not totally eliminate, your Social Security benefit. For additional information, please refer to Social Security Publication, “Windfall Elimination Provision.” Government Pension Offset Provision Under the Government Pension Offset Provision, any Social Security spouse or widow(er) benefit to which you become entitled will be offset if you also receive a Federal, State or local government pension based on work where you did not pay Social Security tax. The offset reduces the amount of your Social Security spouse or widow(er) benefit by two-thirds of the amount of your pension. For example, if you get a monthly pension of $600 based on earnings that are not covered under Social Security, two-thirds of that amount, $400, is used to offset your Social Security spouse or widow(er) benefit. If you are eligible for a $500 widow(er) benefit, you will receive $100 per month from Social Security ($500-$400=$100). Even if your pension is high enough to totally offset your spouse or widow(er) Social Security benefit, you are still eligible for Medicare at age 65. For additional information, please refer to Social Security Publication, “Government Pension Offset.” For More Information Social Security publications and additional information, including information about exceptions to each provision, are available at www.socialsecurity.gov. You may also call toll free 1-800-772-1213, or for the deaf or hard of hearing call the TTY number 1-800-325-0778, or contact your local Social Security office. I certify that I have received Form SSA-1945 that contains information about the possible effects of the Windfall Elimination Provision and the Government Pension Offset Provision on my potential future Social Security benefits. ________________________________________________________ _______________ Signature of Employee Date

http://www.socialsecurity.gov/

KLEIN INDEPENDENT SCHOOL DISTRICT

AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT (CREDITS)

SUBMITTING INSTRUCTIONS 1. Please sign form in any color, NO BLACK INK 2. Print out and bring this form to Klein Central Office – Payroll Room #211 3. Bring check for verification of your bank routing # and your account # 4. For identity theft protection please DO NOT submit via inter-school mail, fax or email. Forms received by these methods will not be processed. 5. Retain one copy for your records.

NAME KLEIN ID/ #

CHECK ONE: ___ADD NEW ___CHANGE EXISTING ___ CANCEL ___ CHANGE AMOUNT CHECK ONE: ___CHECKING ___SAVINGS Amount $________________ If no specific amount, write ALL. If change, enter new amount.

BANK / DEPOSITORY NAME BANK ROUTING # ACCOUNT #_____________________ Verified by payroll _____ (First nine digits on bottom of check) Verified by payroll _____ The KLEIN ISD is not responsible for overdraft charges that might result from an inactivated account. I hereby authorize KLEIN INDEPENDENT SCHOOL DISTRICT hereinafter to initiate credit entries and, if errors occur, authorize correcting entries to my ACCOUNT indicated below and the depositary name below to credit the same to such account credit entries or change amounts as stated above: SIGNATURE DATE

OFFICE USE ONLY Bank Code # ________ Ded Code # 1530 – 1510 Checking Circle One 1520 – 1500 Savings Bank Code # 578 Ded Code # 1501 – Smart Financial Saving Date Entered: _________ Entered By: _________

I have received information that tells me how to get health care under my employer’s workers’ compensation coverage. If I am hurt on the job and live in a service area described in this information, I understand that:

1. I must choose a treating doctor from the Alliance list of doctors designated as treating doctors. 2. I must go to my treating doctor for all health care for my injury. If I need a specialist, my treating

doctor will refer me. If I need emergency care, I may go to any licensed medical professional within the United States.

3. Even though my treating doctor should refer me to a specialist of providers contracted with the Alliance, I understand that I need to verify that the referral doctor is a member of the Alliance provider panel.

4. The Texas Association of School Boards Risk Management Fund will pay the treating doctor and other Alliance providers for all health care related to my compensable injury.

5. I may have to pay the bill if I receive health care from a provider other than an Alliance provider without prior approval from the Fund.

6. Making a false or fraudulent workers’ compensation claim is a crime that may result in fines and or imprisonment.

7. If I want to change doctors after my first choice, I can only choose from the Alliance list of providers. A third choice requires approval from my adjuster.

_____________________________________________________ / / Signature Date Printed Name I reside at: ____________________________________

Street Address ___________________,______,_________________ City State Zip Code

Name of Employer: Klein ISD Name of Direct Contracting Program: Political Subdivision Workers’ Compensation Alliance (the Alliance) Direct contracting service areas are subject to change. To locate a treating doctor within your area, visit the PSWCA web site at www.pswca.org or call your adjuster at 800-482-7276. To be completed by the employer only Please indicate whether this is the:

Initial Employee Notification Injury Notification (Date of Injury: / / )

DO NOT RETURN THIS FORM TO THE TASB RISK MANAGEMENT FUND UNLESS REQUESTED.

EMPLOYEE ACKNOWLEDGMENT OF THE ALLIANCE DIRECT CONTRACTING PROGRAM

http://www.pswca.org/

EMPLOYEE ACKNOWLEDGMENT OF THE ALLIANCE DIRECT CONTRACTING PROGRAM

RECONOCIMENTO DEL EMPLEADO PARA EL PROGRAMA DE CONTRATAR

DIRECTAMENTE CON MEDICOS He recibido la información que explica como obtener tratamientos médicos si me lastimo en el trabajo. También entiendo si me lastimo en el trabajo:

1. Tengo que escoger un doctor de la lista de Alliance (PSWCAA), que son designados para tratar.

2. Tengo que ir al doctor escogido por mí para tratamiento relacionado a mi lastimadura. Si necesito un especialista, el doctor que escogí tiene que referir me a ese especialista. Si necesito tratamientos de emergencia, yo entiendo que puedo ir a cualesquier doctor licenciado en los Estados Unidos.

3. Si el doctor que escogí me refiere a un especialista, tengo que verificar que el especialista también es aprobado por la PSWCA.

4. La compañía TASB le pagara al doctor escogido por mí y a doctores también que son partidos de PSWCA.

5. Si voy a un doctor que no es aprobado por TASB, y no pertenece al partido de la PSWCA, y no he obtenido aprobación, entiendo que es posible que tendré que pagar esa cuenta.

6. Reportando un reclamo falso de lastimadura en el trabajo es un crimen que pueda resultar en multas o encarcelamiento.

7. Si deseo cambiar doctor después del primer doctor escogido, nada mas puedo escoger de la lista de doctores aprobados por PSWCA. Si deseo cambiar doctor por la tercera ves, tendré que recibir aprobación de mi ajustador de la compañía TASB, antes de cambiar.

Signature (firma):______________________________ Date (Fecha)_________________ Printed Name (Nombre en imprenta): ___________________________________________ Address (Dirección de domicilio incluyendo cuidad, estado y zip):_____________________ _________________________________________________________________________ Employer (Nombre de empleador): Klein ISD Nombre del programa de contratar doctores directamente: POLITICAL SUBDIVISION WORKERS’ COMPENSATION ALLIANCE (PSWCA) El servicio de contratar doctores directamente en las áreas de servicio, son subjetivos a cambiar. Para localizar un doctor de tratamiento en su área, visite al Internet en: www.pswca.org o llame a su ajustador al numero: 800-482-7276. To be completed by the employer only (Para completar por el empleador solamente) Please Indicate whether this is the:

□ Initial Employee Notification □ Injury Notification (Fecha de lastimadura _________)

DO NOT RETURN THIS FOR TO THE TASB RISK MANAGEMENT FUND UNLESS REQUESTED. (NO REGRESE ESTA FORMA A TASB SOLO QUE SEA REQUERIDA)

http://www.pswca.org/

ACKNOWLEDGEMENT OF RECEIPT OF BENEFITS INFORMATION – REVISION 11/2016 |

TIME SENSITIVE (All new hires MUST complete benefit enrollment process within 30 days of hire date)

I understand that I have 30 days from my first day of employment to elect my benefits, including medical, dental, vision, life, critical care, and legal plan options. I understand that if I do not enroll within 30 days, my benefits will be waived/declined on my behalf/for me by Klein ISD. I will be required to wait until the next annual enrollment period, unless a qualified event occurs. http://benefits.ffga.com/kleinisd

I have been informed/told that even if I do not want any benefits, I must go through the enrollment process system in order to officially decline the medical coverage (per the ACA Federal requirement) and also to designate a beneficiary for the $10,000 Basic Life and Accidental Death policy provided by Klein.

I understand that I have the responsibility to educate myself on the available KISD Benefits. I have been told that I can attend a Benefit Meeting* (http://benefits.ffga.com/kleinisd ) to obtain benefit enrollment information prior to signing up for benefits.

I also will review all Benefit Information available to me under the “Klein ISD Benefits” link on the New Hire Packet Page, I understand that all the benefit materials is available to me on-line, accessible from the Benefit Department website (http://benefits.ffga.com/kleinisd). This website is accessible from any computer at http://benefits.ffga.com/kleinisd

Important and Required for Benefits

• Logon to the http://benefits.ffga.com/kleinisd • Enroll in benefits or waive benefits. • Assign a beneficiary for the $10,000 life insurance policy and the Accidental Death policy given to you by KLEIN ISD • Print or email – Summary of Elected Benefits for my records

_____________________________________ ________________________________

Printed Name Employee ID #

_____________________________________ ________________________________

Hire Date Campus/Department

_____________________________________ ________________________________

SIGNATURE Date

Acknowledgement of Receipt of Benefits Information

• The Informational Benefit Meeting schedule – www.kleinisd.net/benefits

• No Registration is required – just BE THERE!

http://benefits.ffga.com/kleinisd





http://www.kleinisd.net/benefits

Pre-Employment Affidavit for Applicant Offered Employment

For purposes of this affidavit:

Adjudication and conviction refer to a conviction, plea of guilty or no contest (nolo

contendre), probation, suspension, or deferred adjudication.

Charge refers to a formal criminal charge as documented by a primary charging instrument

(a complaint, information, or indictment) under the Texas Code of Criminal Procedure.

Inappropriate relationship refers to the crime of improper relationship between educator

and student in Texas Penal Code section 21.12, and any other inappropriate relationship as

determined by the State Board for Educator Certification.

I declare the following:

o I have never been charged with, adjudicated for, or convicted of having an inappropriate

relationship with a minor.

o I have been charged with, adjudicated for, or convicted of having an inappropriate

relationship with a minor. The charge, adjudication, or conviction was determined to be

false. The following are all of the relevant facts pertaining to the charge, adjudication, or

conviction: ___________________________________________________________________________.

o I have been charged with, adjudicated for, or convicted of having an inappropriate

relationship with a minor. The charge, adjudication, or conviction was determined to be

true. The following are all of the relevant facts pertaining to the charge, adjudication, or

conviction: ___________________________________________________________________________.

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Affidavit of Applicant Offered Employment

The following affidavit is offered to satisfy the requirement of Texas Education Code section 21.009 for

a pre-employment affidavit.

I declare under penalty of perjury that the foregoing is true and correct.

_______________________________________________________________________ __________________________________ Name (First, Middle, Last) Date of Birth

_______________________________________________________________________ __________________________________ Address (Street, City, State, Zip Code) County

Executed in ____________________ County, State of Texas, on the ________ day of _____________, __________. County Date Month Year (Signature of Declarant)

State of Texas County of _______________ Before me, _________________________ (insert the name of the notary), on this day personally appeared

____________________ (insert the name of the applicant), known to me [or proved to me on the oath of

____________________ or through ______________________ (description of identity card or other document) to

be the person whose name is subscribed to the foregoing instrument] and acknowledged to me that

he executed the same for the purposes and consideration therein expressed. Given under my hand

and seal of office this __________ day of __________, (year).

(Personalized Seal) _________________________________ Notary Public’s Signature

I understand that the date of birth I am providing will not be used to determine eligibility for employment but will be used solely

for the purpose of this pre-employment affidavit.*

*This form will be processed separately and not shared with the hiring manager.

Approved by the Texas Commissioner of Education, October 2017.