Have questions about documents on this page?

Please contact Barbara Krizen at (585)637-5300 x. 111 or at BKrizen@brockportny.gov

Employee Handbook 2022

Employee Handbook Receipt Acknowledgement

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Bond Benefits – Open Enrollment Kit and OE Presentation

Cancer Screening PTO (Breast/Prostate)

COBRA Reference Guide

Covid Tests – Click on this link to be taken to the page to order them for free

Direct Deposit Form

Domestic Partnership Registration

Excellus Forms Page (Including vision reimbursement form)

Excellus Medical Enrollment Application

Excellus Preventive Drug List (03/2022)

Excellus Telemedicine

Excellus Waiver of Group Coverage

EyeMed Enrollment Form

Harassment Complaint Form

Holiday Schedule 25-26

HRA Enrollment Form

IT 2104 – 2023

LBS Substantiation FAQs

LBS App Information

Medicare 2024 Excellus Medicare Supplemental Application

Medicare Supplement Plan G Information

Medicare 2024 Simply P (Prescriptions) Application

Medicare 2024 Simply P (Prescriptions)  Information

Mutual Of Omaha Enrollment Form (Involuntary Life, Short Term Disability, Dental, Voluntary Life)

Optional Coverages Information

Paid Time Off (PTO) Request

Payroll Calendar 24-25

Retirement Registration Form

Retirement Newsletter-Most Recent (ERS)

Retirement Newsletter-Most Recent (PFRS)

Stetson Club Buy Out Form

W4 – 2023

Workers Compensation C-2F