Fillable Human Resources Department Fairbanks North Star Borough School

Fill Online, Printable, Fillable, Blank Human Resources Department Fairbanks North Star Borough School Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Human Resources Department Fairbanks North Star Borough School

On average this form takes 49 minutes to complete

The Human Resources Department Fairbanks North Star Borough School form is 24 pages long and contains:

  • 9 signatures
  • 95 check-boxes
  • 115 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Human Resources Department
Fairbanks North Star Borough School District
520 Fifth Avenue, Fairbanks, Alaska 99701-4756
Telephone: 907-452-2000, ext 11326; Fax: 907-451-6008
www.k12northstar.org
STUDENT
Employment Packet
2019-2020
School Year
Notice:
Please be advised that Student employment offers no assurance of on-
going work and does not include benefits.
Revised: 1-2020
BECOMING A STUDENT EMPLOYEE FOR THE FAIRBANKS
NORTH STAR BOROUGH SCHOOL DISTRICT
NEW STUDENT PROCESS:
1. Complete an online application on the District website:
http://www.k12northstar.org/departments/hr/jobs.
2. Pre-register for and attend a mandatory Student Employee Orientation.
3. Submit the completed employment packet obtained at hiring location/school to the
Human Resources Department.
RETURNING STUDENT PROCESS:
1. Verify they are an active employee in MUNIS. If so they are active until they
graduated.If they are inactive they will need to complete the new student process.
ORIENTATION INFORMATION:
Orientations are scheduled as needed.
Orientations are held at 520 Fifth Avenue (FNSBSD Administration Center) on the 3
rd
floor.
Call the Human Resources Department at (907
) 452-2000 extension 11326 to schedule to
attend a Student Employee Orientation. Pre-registration is required and orientation is
mandatory.
Please bring the following information to orientation in order to submit a complete
employment packet:
Appropriate identification for the I9 Form is required: This form is to prove you are
eligible to work in the United States. http://w
ww.uscis.gov/sites/default/files/files/
form/i-9.pdf.
Pre-printed deposit slip, voided check, or letter from bank/credit union with routing
and account numbers to initiate direct deposit.
STUDENT EMPLOYMENT PACKET
Instructions and Checklist
Employment packets will be accepted when the following items are completed and
submitted to the Human Resources Office in person by the applicant following
orientation.
***We ONLY accept packets completed in blue or black ink!***
Name of employee (please print) Name of HR Tech conducting orientation
Please check the boxes below once you complete the item
Employment Application – You will need to visit our website and complete the online employment
application at http://www.k12northstar.org/departments/hr/jobs (Student Employee). Once the
Human Resources Department has received your packet, we will download your completed application.
Current Contact Form
Emergency Contact Form
Parental Consent Form – To be signed by parent/guardian for students under age 18. For students
18 or older, complete form and indicate parent signature is not applicable because of age.
Statement of Understanding
I-9 Employment Eligibility Verification – See instructions on attached form.
Confidentiality Statement
EEO Form
W-4
Direct Deposit – Voided check or letter from the bank with routing number and account
number required
Health Questionnaire
----------------------------------------------------------------------------------------------------------------------------------------------
Once this packet has been completed and approved you will remain active as a Student Employee
unless you submit your resignation, you graduate or you receive no pay for one school year. For re-
employment with the district, you would need to complete the entire Student Employee applicant
packet, attend orientation and provide all required documentation.
I acknowledge I have completed the above checklist, attended orientation and received and read the
Student Employee Handbook.
Signature of Employee Date of Orientation
click to sign
signature
click to edit
PARENTAL CONSENT FORM
FOR STUDENT
Date: _____________________
Student’s Name:
F#:
(If known)
School Currently Enrolled In: ______________
______________________
Expect
ed Year of Graduation: ___________________
I affirm that I, ______________________ , am the parent or legal guardian of the
Name (Please print)
above-named minor and that such minor has my consent to be employed in
any occupation authorized by the State and Federal child labor laws and
regulations. I understand that student employment is contingent upon
maintaining active enrollment with the School District. If a student is
expelled from school then student employment with the School District is
also terminated.
Parent/Guardian Signature Date
Revised: 8/16
click to sign
signature
click to edit
CURRENT CONTACT INFORMATION
Name F #
If known
Mailing address
City
State Zip
Physical street address
If different from mailing address
City
State Zip
Telephone # cell  home  other
***If required for position – the telephone number listed above will be your Aesop Log-
in***
Telephone # cell  home  other
Personal Email Address:
Employment status
Certified (FEA/FPA)
Substitute Teacher
Temporary Employee
Classified (ESSA)
Exempt
Student
 Student Intern: School location(s) where interning:
 Coach: School location(s) where coaching:
Signature
Date
click to sign
signature
click to edit
1. I understand that the Fairbanks North Star Borough School District employee /
employer relationship is an “at will” relationship. I understand I have the right to
discontinue my working relationship with the district at any time in writing, for any
reason and without any advance notice given and I acknowledge that the district
reserves these same rights.
2. I understand that I may not work in excess of the Department of Labor standards
and hours described by age in any given work week (Monday – Sunday). Failure to
comply may affect my employment with the Fairbanks North Star Borough School
District.
3. I understand that my position is contingent upon being a student in the Fairbanks
North Star Borough School District and maintaining my eligibility to attend school.
4. I understand that I will be paid $10.19 per hour.
5. I have received and read all of the materials presented at orientation and agree to
abide by all Fairbanks North Star Borough School District policies set forth.
Print name
Signature of Student Employee
Date
STUDENT EMPLOYEE STATEMENT
OF UNDERSTANDING
click to sign
signature
click to edit
CONFIDENTIALITY AGREEMENT
The information you may have access to is NOT public information and
can only be released by specific personnel of the Fairbanks North Star
Borough School District. Never release information to anyone without first
checking with your immediate supervisor. As an employee, volunteer,
substitute or temporary employee, it is very important that all information
that you come in contact with be kept strictly confidential. Never speak of
this data in public places, with mutual friends or family members.
I have signed this form and agree to abide by this policy while I am
assisting with student record handling or employee record handling.
Printed Name
Signature
Date
click to sign
signature
click to edit
EMERGENCY CONTACT & MARITAL
STATUS FORM
All Fairbanks North Star Borough School District employees are responsible for
providing the Human Resources Department with the emergency contact information
and with updating this information as needed.
Employee Name F # (if known)
Work Location
Individual(s) to be contacted in an emergency:
Name Home/Cell Phone
Mailing address Work Phone
Physical Address Relationship to employee
Name Home/Cell Phone
Mailing address Work Phone
Physical Address Relationship to employee
Marital Status: Married Single
This information is only for the state of Alaska Division of Retirement and
Benefits (DRB) for their reporting purposes. The school district sends this
information to DRB.
Employee's Signature Date
click to sign
signature
click to edit
EEO Information
In order to comply with federal workplace regulations, the school district is required to gather
data on gender, ethnicity, veteran status and disability of employees upon initial hire. The data is
used for statistical reporting purposes. This information is voluntary and the school district offers
this opportunity for the employee to self-identify. However, if the employee chooses not to self-
identify his or her ethnicity and/or race, the school district is required to use employment records
or visual observation to make a determination.
Gender Veteran Status
☐ Female ☐ Vietnam Era Veteran
☐ Male ☐ Disabled Veteran
(Mark all that apply)
☐ Asian ☐ Native Hawaiian/Pacific Islander
☐ Alaskan Native ☐ White
☐ American Indian/Native American ☐ Multiple Races
☐ Black or African American ☐ Choose Not to Respond
☐ Hispanic or Latino
____________________________________ ____________________
Employee Name F#
_____________________________________ ____________________
Employee Signature Date
click to sign
signature
click to edit
H:\Human Resources\Gateway\Forms\HR Forms\Health Questionnaire.docx 6/2016
FAIRBANKS NORTH STAR BOROUGH SCHOOL DISTRICT
HEALTH QUESTIONNAIRE
Employee’s Last Name First MI
Position Offered
Information submitted below will be used by the Fairbanks North Star Borough for Workers’ Compensation claims handling purposes. This
includes the determination of eligibility for the Second Injury Fund and documentation of certain pre-existing physical impairments identified in the
Workers’ Compensation laws. (A.S. 23.30.040 & 205)
Please complete Sections 1 and 2 of this form.
SECTION 1:
Have you had any previous injuries or illnesses for which a Workers’ Compensation claim has been filed?
Yes No
If the answer is “yes” to the above question, complete the following box in detail. List additional claims on the back of this form
Type of Injury or Illness
Date Injury or Illness Occurred
Employer Name and Mailing Address
City, State, Zip
Time Off Due to Injury or Illness
Type of disability for which benefits were paid
SECTION 2:
Check any of the following medical conditions which apply to you. If none apply, check the None box below.
I
have completed this form to the best of my recollection and understand that any omissions or falsification may result in an employer
denial of any subsequent workers’ compensation claims that might be pertinent to such data. (AS.23.30.022)
____
_____________________________________ ________________________________
Employee’s Signature Date
Amputated foot, leg, arm or hand Ionizing Radiation Injury
Ankylosis of joints Loss of Sight in one or both eyes or
Arteriosclerosis
Partial loss of Uncorrected Vision of More than 75% bilaterally
Arthritis Multiple Sclerosis
Cardiac Diseases or Disorders Muscular Dystrophies
Cerebral Palsy Osteoporosis
Cerebral Vascular Accident Parkinson's Disease
Chronic Osteomyelitis Residual Disability from Poliomyelitis
Compressed Air Sequelae Ruptured Intervertebral Disk
Diabetes Silicosis
Epilepsy Spondylolisthesis
Heavy Metal Poisoning Thrombophlebitis
Hemophilia Tuberculosis
Hyperinsulinism Varicose Veins
NONE OF THE ABOVE
LISTS OF ACCEPTABLE DOCUMENTS
All documents must be UNEXPIRED
Employees may present one selection from List A
or a combination of one selection from List B and one selection from List C.
LIST A
2. Permanent Resident Card or Alien
Registration Receipt Card (Form I-551)
1. U.S. Passport or U.S. Passport Card
3. Foreign passport that contains a
temporary I-551 stamp or temporary
I-551 printed notation on a machine-
readable immigrant visa
4. Employment Authorization Document
that contains a photograph (Form
I-766)
5. For a nonimmigrant alien authorized
to work for a specific employer
because of his or her status:
Documents that Establish
Both Identity and
Employment Authorization
6. Passport from the Federated States of
Micronesia (FSM) or the Republic of
the Marshall Islands (RMI) with Form
I-94 or Form I-94A indicating
nonimmigrant admission under the
Compact of Free Association Between
the United States and the FSM or RMI
b. Form I-94 or Form I-94A that has
the following:
(1) The same name as the passport;
and
(2) An endorsement of the alien's
nonimmigrant status as long as
that period of endorsement has
not yet expired and the
proposed employment is not in
conflict with any restrictions or
limitations identified on the form.
a. Foreign passport; and
For persons under age 18 who are
unable to present a document
listed above:
1. Driver's license or ID card issued by a
State or outlying possession of the
United States provided it contains a
photograph or information such as
name, date of birth, gender, height, eye
color, and address
9. Driver's license issued by a Canadian
government authority
3. School ID card with a photograph
6. Military dependent's ID card
7. U.S. Coast Guard Merchant Mariner
Card
8. Native American tribal document
10. School record or report card
11. Clinic, doctor, or hospital record
12. Day-care or nursery school record
2. ID card issued by federal, state or local
government agencies or entities,
provided it contains a photograph or
information such as name, date of birth,
gender, height, eye color, and address
4. Voter's registration card
5. U.S. Military card or draft record
Documents that Establish
Identity
LIST B
OR AND
LIST C
8. Employment authorization
document issued by the
Department of Homeland Security
1. A Social Security Account Number
card, unless the card
includes one of
the following restrictions:
2. Certification of Birth Abroad issued
by the Department of State (Form
FS-545)
3. Certification of Report of Birth
issued by the Department of State
(Form DS-1350)
4. Original or certified copy of birth
certificate issued by a State,
county, municipal authority, or
territory of the United States
bearing an official seal
5. Native American tribal document
7. Identification Card for Use of
Resident Citizen in the United
States (Form I-179)
Documents that Establish
Employment Authorization
6. U.S. Citizen ID Card (Form I-197)
(2) VALID FOR WORK ONLY WITH
INS AUTHORIZATION
(3) VALID FOR WORK ONLY WITH
DHS AUTHORIZATION
(1) NOT VALID FOR EMPLOYMENT
Page 3 of 3
Form I-9 11/14/2016 N
Examples of many of these documents appear in Part 8 of the Handbook for Employers (M-274).
Refer to the instructions for more information about acceptable receipts.
USCIS
Form I-9
OMB No. 1615-0047
Expires 08/31/2019
Employment Eligibility Verification
Department of Homeland Security
U.S. Citizenship and Immigration Services
Form I-9 07/17/17 N
Page 1 of 3
►START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically,
during completion of this form.
Employers are liable for errors in the completion of this form.
ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which
document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ
an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.
Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later
than the first day of employment, but not before accepting a job offer.)
Last Name (Family Name) First Name (Given Name)
Middle Initial
Other Last Names Used (if any)
Address (Street Number and Name)
Apt. Number City or Town
State
ZIP Code
Date of Birth (mm/dd/yyyy)
U.S. Social Security Number
-
-
Employee's E-mail Address
Employee's Telephone Number
I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in
connection with the completion of this form.
I attest, under penalty of perjury, that I am (check one of the following boxes):
1. A citizen of the United States
2. A noncitizen national of the United States (See instructions)
3. A lawful permanent resident
4. An alien authorized to work until
(See instructions)
(expiration date, if applicable, mm/dd/yyyy):
(Alien Registration Number/USCIS Number):
Some aliens may write "N/A" in the expiration date field.
Aliens authorized to work must provide only one of the following document numbers to complete Form I-9:
An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number.
1. Alien Registration Number/USCIS Number:
2. Form I-94 Admission Number:
3. Foreign Passport Number:
Country of Issuance:
OR
OR
QR Code - Section 1
Do Not Write In This Space
Signature of Employee
Today's Date (mm/dd/yyyy)
Preparer and/or Translator Certification (check one):
I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1.
(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)
I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my
knowledge the information is true and correct.
Signature of Preparer or Translator
Today's Date (mm/dd/yyyy)
Last Name (Family Name) First Name (Given Name)
Address (Street Number and Name)
City or Town
State
ZIP Code
Employer Completes Next Page
Form I-9 07/17/17 N
Page 2 of 3
USCIS
Form I-9
OMB No. 1615-0047
Expires 08/31/2019
Employment Eligibility Verification
Department of Homeland Security
U.S. Citizenship and Immigration Services
Section 2. Employer or Authorized Representative Review and Verification
(Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You
must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists
of Acceptable Documents.")
Last Name (Family Name) M.I.First Name (Given Name)
Employee Info from Section 1
Citizenship/Immigration Status
List A
Identity and Employment Authorization
Identity
Employment Authorization
OR List B AND List C
Additional Information
QR Code - Sections 2 & 3
Do Not Write In This Space
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee,
(2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the
employee is authorized to work in the United States.
The employee's first day of employment (mm/dd/yyyy):
(See instructions for exemptions)
Signature of Employer or Authorized Representative
Today's Date (mm/dd/yyyy)
Title of Employer or Authorized Representative
Last Name of Employer or Authorized Representative First Name of Employer or Authorized Representative
Employer's Business or Organization Name
Employer's Business or Organization Address (Street Number and Name)
City or Town
State
ZIP Code
Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.)
A. New Name (if applicable)
Last Name (Family Name)
First Name (Given Name) Middle Initial
B. Date of Rehire (if applicable)
Date (mm/dd/yyyy)
Document Title Document Number
Expiration Date (if any) (mm/dd/yyyy)
C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes
continuing employment authorization in the space provided below.
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if
the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual.
Signature of Employer or Authorized Representative
Today's Date (mm/dd/yyyy)
Name of Employer or Authorized Representative
FNSBSD
520 Fifth Avenue
Fairbanks
AK
99701
click to sign
signature
click to edit
H:\_Shared Folder\Shared HR & Payroll\Forms\Auto deposit form - revised 2017-5.docx
FAIRBANKS NORTH STAR BOROUGH SCHOOL DISTRICT
Automatic Deposit Plan
I authorize the Fairbanks North Star Borough School District Payroll Department to initiate the changes I have indicated below:
Financial Institution: Routing # Account#
Checking Full paycheck or set $ amount
Savings
Financial Institution: Routing # Account#
Checking Dollar Amount
Savings
Financial Institution: Routing # Account#
Checking Dollar Amount
Savings
Financial Institution: Routing # Account#
Checking Dollar Amount
Savings
Financial Institution: Routing # Account#
Checking Dollar Amount
Savings
• Acceptable documents are: Voided Check, Copy of Check, Membership Card.
• Documents must include account and routing information.
• Supporting documents must reflect legal name of employee on the account.
Auto deposit (Auto deposit required for FEA, FPA, ESSA, Exempt per contract)
Adding new account – auto deposit **
Delete account listed above from multiple deposits
Change of Bank / Account Number / Dollar Amount
Leave existing account in effect until new account activated
Account is closed - do not submit to account or bank
Cancel auto deposit. (Not valid for active Exempt, FEA, FPA or ESSA members)
**Auto deposit will take effect within the following pay period once the payroll department receives appropriate documentation.
Employee Number (F#) Print Name Clearly
Date
Signature
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Human Resources Department Fairbanks North Star Borough School

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 26 August 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document