Benefit Eligible School Employees

Welcome to the Lunenburg Public Schools. As a new hire, there are many forms you must complete before your payroll record can be created and your first paycheck issued. The following must be printed out, completed, and returned, in person, along with the appropriate documentation, to Nancy Forest in Town Hall.

• Employee Information Sheet (PDF)
• W-4 Federal Tax Form (PDF)
• M-4 Massachusetts Employee's Withholding (PDF)
• I-9 Employment Eligibility Verification (PDF) - Acceptable forms of identification, as noted on the I-9 form must be presented in person by the employee.
• I-9 Form and Instructions (PDF)
• Payroll Direct Deposit Form (PDF) - Attach a voided check or bank authorization form
• W-2 Electronic Consent Form (PDF)
• Massachusetts Teachers Retirement System (PDF) - For teachers and administration
• Worcester Regional Retirement System (PDF) - For all other benefit-eligible employees - A copy of the birth certificate is required
• Worcester Regional Retirement Beneficiary Selection Form (PDF)
• Form 1945 SSA Statement Concerning Your Employment in a Job Not Covered by Social Security (PDF)
• Payroll Election Form (PDF)- Teachers Only
• Waiver of Insurance Coverage (PDF) - Complete if not electing Health, Dental, OR Life Insurance

Please read the following Policies and return the one-page "Employment Policies Receipt"   Policies that need to be printed.

• Use of Information Technology Resources Policy (PDF)
• Sexual Harassment Policy (PDF)
• Harassment of Individuals in Protected Classes (PDF)
• ADA Policy (PDF)
• Social Media Policy (PDF)
• Domestic Violence Leave Policy (PDF)
• Family Medical Leave Policy (PDF)
• Parental Leave Policy (PDF)
• Standards of Conduct Policy (PDF)
• Workplace Violence Policy (PDF)
• Pregnant Workers Fairness Act Policy (PDF)
• Employment Policies Receipt (PDF)

Please read the Conflict of Interest Policy and return the signed receipt

• Conflict of Interest/Financial Disclosure (PDF) - Read, and return the receipt
• Conflict of Interest Law Receipt (PDF)
• Affordable Care Act (PDF) - For Your Information