BUSD Benefits Dept

• Employee Assistance Program
• Employee Assistance Program
• 2024 Rate Sheets
• 2024 Adult school Contribution Rate Sheet
• 2024 BCCE Contribution Rate Sheets
• 2024 BFT Contribution Rate Sheets
• 2024 Local 21 Contribution Rate Sheets
• 2024 Non-Represented Certificated Contribution Rate Sheets
• 2024 Non-Represented Classified Contribution Rate Sheets
• 2024 Early Childhood Education Contribution Rate Sheets
• 2024 UBA Contribution Rate Sheets
• Fillable Benefit Forms
•  Lincoln Beneficiary Form
•  Lincoln Change Request Form
•  Lincoln Change Request Form
•  Lincoln Enrollment Form
•  Lincoln EOI Instruction
•  Lincoln Adjustment Report
•  Delta Dental Dual Choice Fillable Form
•  VSP Enrollment & Change Form Fillable
•  BASIC Pacific FSA Enrollment Form Fillable
•  BASIC Pacific P&T Enrollment Change Form Fillable
•  BASIC Pacific Mid-Year change form
•  CalPERS Health Benefits Enrollment Form (HBD-12)
•  CalPERS Affidavit of Marriage/Domestic Partnership Form
•  CalPERS Medical Report for Disabled Dependents
•  CalPERS Questionnaire for Disabled Dependents
•  CalPERS COBRA continuation of Coverage Form
•  CalPERS COBRA Continuation of Coverage Retiree
•  Lincoln Financial Evidence of Insurability (EOI) Form
•  Lincoln Voluntary Term Life Employee Enrollment Form
•  Lincoln Voluntary Term Life Employee Enrollment Form – Fillable
•  Cash in Lieu Form
•  Domestic Partnership Application/Affidavit
• Debit Cards for FSA & Transit Accounts (BASIC pacific)
• Dependent Care
• Commuter Accounts
• FSA
• MyCash Account

BUSD Employee Forms and Information

• Mandated Reporting of Suspected Child Abuse
• Suspected Child Abuse Reporting Form
• Suspected Child Abuse Reporting Instructions
• Elder Abuse Reporting Form
• Sexual Harassment Policy and Reporting Procedures
• BUSD Sexual Harassment Policy, complaint form, and additional resources.
• Employment Forms
• Certificated Inservice Hours – IEP & SST
• Certificated Inservice Hours – Non IEP/SST
• Certificated – Transcript Submission Evaluation or Balance Inquiry Request
• Change of Address, Telephone or Name Form
• Designation of Beneficiary
• Emergency Contact Information
• Leave Request 21-22, All Employees
• Certificated Leave Request Form
• Classified Leave Request Form
• NCLB Certificate of Compliance
• Personnel Status Change Form
• Professional Growth Policies & Procedures
• Reasonable Accommodations
• Request for Course Approval
• Request for Information from Medical Provider
• Request for Paid Sick Leave for Substitute Employees
• Separation from BUSD Form
• Classified Verification of Work Experience & Sick Leave Balance 
• Certificated Verification of of Experience and Sick Leave Transfer Forms
• Substitute Medical Stipend Application
• Vacation Leave Request Form

BUSD Human Resources Dept

• For Employment Verifications and Personnel file reviews please contact HR@Berkeley.net
• Escape Employee Online Portal (EOP)
• Frontline Absence Management
• Open Classified Positions
• Classified Job Descriptions(ALL)
• Employee Handbook 2019-20
• Substitute Teachers’ Handbook 2023-24
• Holiday Calendar for 2023-24
• Teacher Induction Program (TIP)
• Human Resources and Personnel Commission Organizational Chart
• Union Contracts, Calendars and Salary Schedules

BUSD Payroll Dept

• 2023-2024 Pay Dates
• 2023-2024 Holiday Calendar
• Direct Deposit Form
• Request to Cancel Direct Deposit
• 2023 W-4 Form
• IRS W4 withholding estimator
• DE4 State Withholding Form
• E-Timesheets
• E-Timesheets Instructions
• Classified E-Timesheet
• Employee Information – EOP
• Escape Employee Online Portal (EOP)
• Retirement
• CalPERS Online
• CalSTRS Online
• Tax Sheltered Annuities (TSA’s)
• Meaningful Notice / Plan Summary Information 2022
• 403b and 457 Plan Approved Vendors

BUSD Risk Management Dept

• If you are injured at work…READ THIS
• Risk Management Downloadable Forms
• Confidential School Incident Report
• Request for Proof of Insurance (for Field Trips, etc.)
• Report of Hazard   [RM-01]
• Safety Suggestion Form
• Claim for Damages
• School Parade Guidelines
• School Parade Guidelines for Participants
• Student Injury Claim Reporting Procedures, Instructions and Form – English
• Student Injury Claim Form – Spanish
• Student Accident and Sickness Insurance
• Accidente Estudiantil y Seguro de Enfermedad 
• Workers’ Compensation Downloadable Forms
• Report of Incident [RM-03]
• Witness Statement [RM-04]
• Supervisor’s Report of Investigation [RM-05]
• Workers’ Compensation Claim Form [DWC-1]
• Acknowledgement of Receipt
• Notice to Employees [DWC-7]
• Aviso a los Empleados [DWC-7]
• BUSD Workers’ Compensation Policy
• TargetSolutions Online Training
• TargetSolutions Online Training