Grievance Forms
PPA Forms
PPA Membership Application & Payroll Deduction
Verizon Forms
Regional Work and Family Program forms 2024
Work and Family Initiatives overview 2024
Dependent Care Application 2024
Dependent Care Monthly Reimbursement Form 2024
Defensive Driving Reimbursement Program 2024
Educational Reimbursement (college books and materials) 2024 increased
Health and Wellness Program (incl gym reimbursement) 2024 increased
High School Driver Education (2024)new
Pendant Program Application (2024)
Pendant Program Quarterly Reimbursement Form (2024)
Summer Camp Flyer (2024) increased
Summer Camp Application (2024)
Tutoring Reimbursement (2024) new
Anticipated Disability Form Verizon
Sedgwick Attending Physician Statement Behavioral Health
Sedgwick Attending Physician Statement
NOTE: FMLA forms are now sent directly from Sedgwick, upon initiation of a claim. The reporting process remains the same, beginning with a call out to your supervisor or absence administrator.
CWA LOCAL 1101 FORMS
Employer Unfair Labor Practices
Prudential Beneficiary Form Jan 5, 2022
(please fill out, sign and return to CWA Local 1101, Atten: Kevin Condy, 350 West 31 St, 2nd Fl, NY NY 10001)
Payroll Voucher CWA Local 1101
CWA District 1 PAF Card fillable (fill out and return to CWA Local 1101, 350 W 31 St, 2nd Fl, NY NY 10001)