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		Time Sheets, Mileage, Request for Leave or Out of Area Travel PDF file: looks like a regular form. To download PDF files you need Adobe Reader. Once downloaded, print the form out on canary paper. Excel file: If you have Excel, first save the form in this format. Fill out the top part with your information and use it as a template each time. In many places the totals will be entered for you! Save. Print out on canary paper. Note: Some people need to adjust their margins on these forms. TIME SHEETS Agency Time Sheet, Non-Exempt – PDF file revised 10/07 Agency Time Sheet, Non-Exempt -- Excel file revised 10/07 Agency Time Sheet, Exempt –Excel file REQUEST FOR LEAVE Request for Leave Form -- PDF file Request for Leave Form -- Excel file MILEAGE Employment and Training mileage form – Excel file Housing and Weatherization mileage form – Excel file Head Start mileage form – Excel file OUT OF AREA TRAVEL Out of Area Travel form, side 1 Report on Meeting/Training Event	INSURANCE Anthem Enrollment form - Use this form for new enrollment or adding a dependent. Can only enroll as a new hire, or during open enrollment, generally at the end of the year. Can only add dependent if you have a family status change (check with Human Resources, Teri Schweiss, x1108) or during open enrollment. Anthem Change form – only used during open enrollment, or a family status change. Call Human Resources, Teri Schweiss, x1108, if you are not sure which form to use. Delta Dental Enrollment form EMAA EMPLOYEE PERFORMANCE EVALUATIONS Non-Supervisory Evaluation (Excel) Supervisory Evaluation (Excel) Instruction Sheet for Completing a Performance Evaluation Employee Preparation and Self-Appraisal Prior to Annual Performance Evaluation (choose one format from below): PDF format – download and print out MS Word format – download; change margins to: 1” top, .5” bottom, .75” sides; type up your self appraisal; print EMPLOYMENT INTERVIEWS/REFERENCE CHECK Request for Job Announcement Job Interview Report Pre-Employment Reference Check REPORT OF INJURY (Workers’ Compensation) Fill out the Report of Injury form following the directions below: 1) Do not fill out the first two sections of the form. You do not have the needed information. 2) Begin where it says ‘Employee’ and fill out the rest of the form. 3) Three places refer to a CODE. You do not have to fill those places out. 5) Print out and give to the Human Resources Coordinator who will fill out the top part and the codes. OTHER FORMS W-4 form – this is a fillable and printable form. Note: Please contact the web builder if the most current form does not appear sometime shortly after the new year. Thanks! W-9 form—this is a fillable and printable form. Have anyone who contracts with us for services fill this out. Scholarship Application MO Income Calculator
East Missouri Action Agency, Inc. NOT copyrighted—feel free to use to help alleviate poverty. Updated 11/07 Site pages maintained by EMAA community action people.