List of FCPS Forms to Search Search the forms that FCPS provides across various programs and departments. FCPS Forms and Documents Search Displaying 51 - 100 of 307 results FS 73 11: Electronic Pay Advice Agreement Used by FCPS staff to agree to payment via electronic means. PDF iconEnglish (English) FS 73 54: Request for Stop Payment of Payroll Check Used by FCPS staff to request a stop payment of a paycheck. PDF iconEnglish (English) FS 73 66: Request for Reissue of W-2 Used by FCPS staff to request a reissue of a W-2. PDF iconEnglish (English) FS 73 82: Time and Leave Report Used by FCPS staff to request leave or report time and attendance. PDF iconEnglish (English) FTS 001: ADA Grievance Form, Accessibility Used to file a grievance due to inability to properly access sites or services at FCPS. PDF iconEnglish (English) Grade 6 Sexual Harassment Opt-Out Form PDF iconالعربية (Arabic) PDF iconEnglish (English) PDF iconespañol (Spanish) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) PDF icon中文 (Chinese) Grades 4-6 Sexual Harassment Opt-Out Form for Students with Low-Incidence Disabilities PDF iconالعربية (Arabic) PDF iconEnglish (English) PDF iconespañol (Spanish) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) PDF icon中文 (Chinese) HOPE Rating Scale (AAP) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconEnglish (English) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) HR - Application Reference Form Employee reference form for work in Fairfax County Public Schools. PDF iconEnglish (English) HR 106: Non School-Based Administrator's Self-Assessment Used by non school-based FCPS administrators for self-assessment. PDF iconEnglish (English) HR 11: Temporary Assignment Online Time Information Form To assist in the filling out of the MyTime time sheet. PDF iconEnglish (English) HR 110: Support Employee Self-Assessment Used by FCPS operational employees for self-assessments. PDF iconEnglish (English) HR 114: Instructional Assistant Self-Assessment Used by FCPS instructional assistants (IA's) for an optional self-assessment. PDF iconEnglish (English) HR 124: Medical and Dental Enrollment/Change Form Used by FCPS employees to enroll in and change their medical and dental plans. PDF iconEnglish (English) HR 125: Employment Reference Used by FCPS to get reference evaluations for prospective applicants. PDF iconEnglish (English) HR 126: Request for a Foreseeable Family Medical Leave Used by FCPS employees to request foreseeable family medical leave in advance. PDF iconEnglish (English) HR 134: Spouse Health Plan Eligibility and Deduction Authorization, both spouses employees Used by FCPS employees to apply for the health plan two employee spouse discount. PDF iconEnglish (English) HR 141: Medical, Dental, and Health Care FSA HIPAA Plans’ Authorization Used by FCPS employees to authorize use or disclosure of health information related to HIPAA or FSA accounts. PDF iconEnglish (English) HR 143: Group Term Life Insurance Beneficiary Designation Form for FCERS members Used by FCPS staff to change their designated beneficiary on group life insurance. (FCERS only) PDF iconEnglish (English) HR 146: Certification of Health Care Provider for Employee's Serious Health Condition (Family and Medical Leave Act) Used by FCPS staff in the FMLA process for self. PDF iconEnglish (English) HR 147: Certification of Health Care Provider for Family Member's Serious Health Condition (Family and Medical Leave Act) Used by FCPS staff in the FMLA process for family member. PDF iconEnglish (English) HR 148: Certification for Serious Injury or Illness of Covered Servicemember--for Military family Leave (Family and Medical Leave Act) Used by FCPS staff in the FMLA process for covered service member illness/injury. PDF iconEnglish (English) HR 149: Certification of Qualifying Exigency for Military Family Leave (Family and Medical Leave Act) Used by Benefit Services staff to certify a qualifying exigency for military request for FMLA. PDF iconEnglish (English) HR 153: Complaint of Alleged Discrimination Used by FCPS staff to make a complaint of discrimination to the equity and compliance group. PDF iconEnglish (English) HR 157: Request for an Unpaid Long-Term Leave of Absence-On-Loan Used by FCPS staff to request unpaid long term leave of absence. PDF iconEnglish (English) HR 178: Integrated Disability Management (IDM) Program Short Term Disability Benefits Option to Use Available Leave Balances Form Used by FCPS staff to use accrued leave for short term disability. PDF iconEnglish (English) HR 180: Certification of Health Care Provider for Employee's Serious Health Condition (Leave of Absence) Medical certification form used by FCPS employees when applying for a designated leave of absence for an employee's serious health condition. PDF iconEnglish (English) HR 181: Certification of Health Care Provider for Family Member's Serious Health Condition (Leave of Absence) Medical certification form used by FCPS employees when applying for a designated leave of absence for a family member's serious health condition. PDF iconEnglish (English) HR 2: Notification of Resignation or Retirement Used by FCPS staff to officially inform HR of intent to resign or retire. PDF iconEnglish (English) HR 200: Teacher Alternative Student Survey Used by students in alternative schools to provide feedback to teachers. PDF iconEnglish (English) HR 201: Teacher Student Survey Summary Used by FCPS teachers to create a summary of student opinion surveys. PDF iconEnglish (English) HR 202: Teacher Goal Setting for Student Progress Used by FCPS teachers to set goals for student improvement. PDF iconEnglish (English) HR 203: Teacher Pre-Observation Conference Record Used by school administrators to conduct a classroom observation. PDF iconEnglish (English) HR 204: Teacher Structured Interview Used by school administrators to conduct structured interviews of potential teachers. PDF iconEnglish (English) HR 205: Teacher Observation Form 1 Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English) HR 206: Teacher Observation Form 2 Observation/Document Review Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English) HR 207: Teacher Observation Form 3 Observation/Document Review Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English) HR 208: Teacher Observation Form 4 Time on Task Chart Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English) HR 209: Teacher Observation Form 5 Questioning Techniques Analysis Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English) HR 211: Teacher Performance Improvement Plan Used by school administrators to create a teacher performance improvement plan. PDF iconEnglish (English) HR 212: Teacher Communication Log Used by FCPS teachers to create a communication log while on a performance improvement plan. PDF iconEnglish (English) HR 213: Teacher Professional Development Log Used by FCPS teachers to create a professional development log while on a performance improvement plan. PDF iconEnglish (English) HR 217: Instructional Resource Professional Self-Assessment Used by instructional resource staff to conduct a self-assessment. PDF iconEnglish (English) HR 220: Instructional Resource Professional Performance Improvement Plan Used by school administrators to create a performance improvement plan for instructional resources. PDF iconEnglish (English) HR 221: Instructional Resource Professional Structured Interview Used by school administrators to conduct structured interviews of potential instructional resources. PDF iconEnglish (English) HR 222: Instructional Resource Professional Observation Form 1 Used by school administrators to conduct a classroom observation for an instructional resource evaluation. PDF iconEnglish (English) HR 223: Instructional Resource Professional Observation Form 2 Observation/Document Review Used by school administrators to conduct a classroom observation for an instructional resource evaluation. PDF iconEnglish (English) HR 224: Instructional Resource Professional Observation Form 3 Observation/Document Review Used by school administrators to conduct a classroom observation for an instructional resource evaluation. PDF iconEnglish (English) HR 225: Instructional Resource Professional Observation Form 4 Observation Time on Task Chart Used by school administratos to conduct a time on chart for an instructional resource improvement plan. PDF iconEnglish (English) HR 226: Instructional Resource Professional Observation Form 5 Questioning Techniques Analysis Used by school administratos to create an effective questioning technique application for an instructional resource. PDF iconEnglish (English) First Previous1 Currently on page 2 34567Next Last
FS 73 11: Electronic Pay Advice Agreement Used by FCPS staff to agree to payment via electronic means. PDF iconEnglish (English)
FS 73 54: Request for Stop Payment of Payroll Check Used by FCPS staff to request a stop payment of a paycheck. PDF iconEnglish (English)
FS 73 66: Request for Reissue of W-2 Used by FCPS staff to request a reissue of a W-2. PDF iconEnglish (English)
FS 73 82: Time and Leave Report Used by FCPS staff to request leave or report time and attendance. PDF iconEnglish (English)
FTS 001: ADA Grievance Form, Accessibility Used to file a grievance due to inability to properly access sites or services at FCPS. PDF iconEnglish (English)
Grade 6 Sexual Harassment Opt-Out Form PDF iconالعربية (Arabic) PDF iconEnglish (English) PDF iconespañol (Spanish) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) PDF icon中文 (Chinese)
Grades 4-6 Sexual Harassment Opt-Out Form for Students with Low-Incidence Disabilities PDF iconالعربية (Arabic) PDF iconEnglish (English) PDF iconespañol (Spanish) PDF iconفارسی (Farsi) PDF icon한국어 (Korean) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese) PDF icon中文 (Chinese)
HOPE Rating Scale (AAP) PDF iconالعربية (Arabic) PDF icon中文 (Chinese) PDF iconEnglish (English) PDF icon한국어 (Korean) PDF iconespañol (Spanish) PDF iconاردو (Urdu) PDF iconTiếng Việt (Vietnamese)
HR - Application Reference Form Employee reference form for work in Fairfax County Public Schools. PDF iconEnglish (English)
HR 106: Non School-Based Administrator's Self-Assessment Used by non school-based FCPS administrators for self-assessment. PDF iconEnglish (English)
HR 11: Temporary Assignment Online Time Information Form To assist in the filling out of the MyTime time sheet. PDF iconEnglish (English)
HR 110: Support Employee Self-Assessment Used by FCPS operational employees for self-assessments. PDF iconEnglish (English)
HR 114: Instructional Assistant Self-Assessment Used by FCPS instructional assistants (IA's) for an optional self-assessment. PDF iconEnglish (English)
HR 124: Medical and Dental Enrollment/Change Form Used by FCPS employees to enroll in and change their medical and dental plans. PDF iconEnglish (English)
HR 125: Employment Reference Used by FCPS to get reference evaluations for prospective applicants. PDF iconEnglish (English)
HR 126: Request for a Foreseeable Family Medical Leave Used by FCPS employees to request foreseeable family medical leave in advance. PDF iconEnglish (English)
HR 134: Spouse Health Plan Eligibility and Deduction Authorization, both spouses employees Used by FCPS employees to apply for the health plan two employee spouse discount. PDF iconEnglish (English)
HR 141: Medical, Dental, and Health Care FSA HIPAA Plans’ Authorization Used by FCPS employees to authorize use or disclosure of health information related to HIPAA or FSA accounts. PDF iconEnglish (English)
HR 143: Group Term Life Insurance Beneficiary Designation Form for FCERS members Used by FCPS staff to change their designated beneficiary on group life insurance. (FCERS only) PDF iconEnglish (English)
HR 146: Certification of Health Care Provider for Employee's Serious Health Condition (Family and Medical Leave Act) Used by FCPS staff in the FMLA process for self. PDF iconEnglish (English)
HR 147: Certification of Health Care Provider for Family Member's Serious Health Condition (Family and Medical Leave Act) Used by FCPS staff in the FMLA process for family member. PDF iconEnglish (English)
HR 148: Certification for Serious Injury or Illness of Covered Servicemember--for Military family Leave (Family and Medical Leave Act) Used by FCPS staff in the FMLA process for covered service member illness/injury. PDF iconEnglish (English)
HR 149: Certification of Qualifying Exigency for Military Family Leave (Family and Medical Leave Act) Used by Benefit Services staff to certify a qualifying exigency for military request for FMLA. PDF iconEnglish (English)
HR 153: Complaint of Alleged Discrimination Used by FCPS staff to make a complaint of discrimination to the equity and compliance group. PDF iconEnglish (English)
HR 157: Request for an Unpaid Long-Term Leave of Absence-On-Loan Used by FCPS staff to request unpaid long term leave of absence. PDF iconEnglish (English)
HR 178: Integrated Disability Management (IDM) Program Short Term Disability Benefits Option to Use Available Leave Balances Form Used by FCPS staff to use accrued leave for short term disability. PDF iconEnglish (English)
HR 180: Certification of Health Care Provider for Employee's Serious Health Condition (Leave of Absence) Medical certification form used by FCPS employees when applying for a designated leave of absence for an employee's serious health condition. PDF iconEnglish (English)
HR 181: Certification of Health Care Provider for Family Member's Serious Health Condition (Leave of Absence) Medical certification form used by FCPS employees when applying for a designated leave of absence for a family member's serious health condition. PDF iconEnglish (English)
HR 2: Notification of Resignation or Retirement Used by FCPS staff to officially inform HR of intent to resign or retire. PDF iconEnglish (English)
HR 200: Teacher Alternative Student Survey Used by students in alternative schools to provide feedback to teachers. PDF iconEnglish (English)
HR 201: Teacher Student Survey Summary Used by FCPS teachers to create a summary of student opinion surveys. PDF iconEnglish (English)
HR 202: Teacher Goal Setting for Student Progress Used by FCPS teachers to set goals for student improvement. PDF iconEnglish (English)
HR 203: Teacher Pre-Observation Conference Record Used by school administrators to conduct a classroom observation. PDF iconEnglish (English)
HR 204: Teacher Structured Interview Used by school administrators to conduct structured interviews of potential teachers. PDF iconEnglish (English)
HR 205: Teacher Observation Form 1 Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English)
HR 206: Teacher Observation Form 2 Observation/Document Review Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English)
HR 207: Teacher Observation Form 3 Observation/Document Review Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English)
HR 208: Teacher Observation Form 4 Time on Task Chart Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English)
HR 209: Teacher Observation Form 5 Questioning Techniques Analysis Used by school administrators to conduct a classroom observation for a teacher evaluation. PDF iconEnglish (English)
HR 211: Teacher Performance Improvement Plan Used by school administrators to create a teacher performance improvement plan. PDF iconEnglish (English)
HR 212: Teacher Communication Log Used by FCPS teachers to create a communication log while on a performance improvement plan. PDF iconEnglish (English)
HR 213: Teacher Professional Development Log Used by FCPS teachers to create a professional development log while on a performance improvement plan. PDF iconEnglish (English)
HR 217: Instructional Resource Professional Self-Assessment Used by instructional resource staff to conduct a self-assessment. PDF iconEnglish (English)
HR 220: Instructional Resource Professional Performance Improvement Plan Used by school administrators to create a performance improvement plan for instructional resources. PDF iconEnglish (English)
HR 221: Instructional Resource Professional Structured Interview Used by school administrators to conduct structured interviews of potential instructional resources. PDF iconEnglish (English)
HR 222: Instructional Resource Professional Observation Form 1 Used by school administrators to conduct a classroom observation for an instructional resource evaluation. PDF iconEnglish (English)
HR 223: Instructional Resource Professional Observation Form 2 Observation/Document Review Used by school administrators to conduct a classroom observation for an instructional resource evaluation. PDF iconEnglish (English)
HR 224: Instructional Resource Professional Observation Form 3 Observation/Document Review Used by school administrators to conduct a classroom observation for an instructional resource evaluation. PDF iconEnglish (English)
HR 225: Instructional Resource Professional Observation Form 4 Observation Time on Task Chart Used by school administratos to conduct a time on chart for an instructional resource improvement plan. PDF iconEnglish (English)
HR 226: Instructional Resource Professional Observation Form 5 Questioning Techniques Analysis Used by school administratos to create an effective questioning technique application for an instructional resource. PDF iconEnglish (English)