For the convenience of WSESU employees, several forms are now available to print from this page, in PDF format. Please read all requirements carefully when filling out the forms, and call the WSESU Central Office with any questions.
Human Resources & Benefits
VEHI (Vermont Education Health Initiative):
State of Vermont:
Madlyn Moore Award Information
Madlyn Moore Extension Information
- VEHI/BCBSVT Benefits Guide
- VEHI FY21 Health Rates Approved
- VEHI FY21 Health Rate Renewal Announcement for Active Employees
- VEHI 2021 Health Plan Changes - Decision Support Site
- VEHI/BCBSVT Enrollment/Change Form
- VEHI Domestic Partnership Form
- FFCRA (Families First Coronavirus Response Act) Information
- FMLA Information
- Employee's Claim and Employer First Report of Injury
- Exchange Notice of Coverage
State of Vermont:
- Arbitration Award and Resolution of Negotiations - Provisions of 16 V.S.A. Chapter 61
- Health Declaration Form
Madlyn Moore Award Information
Madlyn Moore Extension Information
Payroll Items
Pay Date Schedule 2020-2021
Pay Date Schedule 2019-2020
Credit Union Form
Direct Deposit Form
Direct Deposit Form for Substitute Teachers
403 (b) Financial Rep List
403 (b) Salary Reduction Agreement -please choose your employer: WSESD VTSD, WSESU
2020 Federal W-4 Form
VT State W-4 Form
Payroll Change Notice/Goldenrod
Request for Pay - Certified Staff
Pay Date Schedule 2019-2020
Credit Union Form
Direct Deposit Form
Direct Deposit Form for Substitute Teachers
403 (b) Financial Rep List
403 (b) Salary Reduction Agreement -please choose your employer: WSESD VTSD, WSESU
2020 Federal W-4 Form
VT State W-4 Form
Payroll Change Notice/Goldenrod
Request for Pay - Certified Staff
Expense Items
Expense Reconciliation Form
Funds Advance Request Form
New Mileage Reimburse Form 1-2-20
New Requisition Form - 8-31-2020
One Percent Application
Funds Advance Request Form
New Mileage Reimburse Form 1-2-20
New Requisition Form - 8-31-2020
One Percent Application
Credit Equivalency
L/RSB Forms (WSESU Re-Licensure forms and links to the Agency of Education (AOE))
Professional Learning Approval Form (as of March 2018)
Self Assessment on Teaching Practice from AOE (as of March 2018)
Self Assessment Verification form from AOE (as of March 2018)
ALIS: VT AOE Online Licensing System for Educators
VT Re-licensure FAQ's and Tutorials for licensure
VT AOE License Renewal Main Page
Self Assessment on Teaching Practice from AOE (as of March 2018)
Self Assessment Verification form from AOE (as of March 2018)
ALIS: VT AOE Online Licensing System for Educators
VT Re-licensure FAQ's and Tutorials for licensure
VT AOE License Renewal Main Page
Wellness