Forms

Job Applications

  1. Civil Service Application (PDF)
  2. General Application (PDF)

Public Forms

  1. Authority to Release Private Information Form (PDF)
  2. Grievance Form-Complaint Questionnaire (PDF)
  3. Public Records Request Form (PDF)
  4. Request to Correct or Amend PHI (PDF)
  5. Revocation of Authorization for Use / Disclosure of PHI (PDF)
  6. Violent Act / Threat Report Form (PDF)

Employee Only Forms

  1. Accident-Incident Report Form (PDF)
  2. Authority to Release Private Information Form (PDF)
  3. Direct Deposit Authorization Form
  4. Grievance Form-Complaint Questionnaire (PDF)
  5. Hours Certification Form for Elected and Exempt Employees (PDF)
  6. Public Records Exemption Log (PDF)
  7. Request to Correct or Amend PHI (PDF)
  8. Revocation of Authorization for Use / Disclosure of PHI (PDF)
  9. Sick Bank Donation Form
  10. Sick Leave Conversion Form (PDF)
  11. Violent Act / Threat Report Form (PDF)

Employment Documents

  1. I-9 Form and Acceptable Documents
  2. Federal W-4 2021
  3. IDAHO W4 2021
  4. Whitman County Employee Data Sheet
  5. Direct Deposit Authorization Form
  6. Email-Internet Policies acknowledgement
  7. Employee Safety Security Orientation Checklist
  8. Payroll Deduction Authorization
  9. Salary Redirection Agreement
  10. Policy Acknowledgements
  11. Confidentiality Statement
  12. Employee Paid Sick Leave Notification
  13. 02_Exchange_Notice_081513 - Copy
  14. Teamster Participant Data Form
  15. Whitman County New Employee Checklist

Orientation Policies and Procedures

  1. Overseeing Email Internet Policy
  2. PERSONNEL POLICY SUMMARY 2021
  3. Notice of Leave Policies
  4. Privacy Policy
  5. HIPAA Privacy Notice
  6. EEO Policy
  7. Work Place Violence policy
  8. Reporting Workplace Violence
  9. Smoking Policy
  10. Maint Drug Free Workplace Policy
  11. Anti-Harassment Policy
  12. Blood Borne Pathogen Policy
  13. New Hire Clock In Reference Sheet

Orientation - Retirement

  1. 03_Retirement Status Verification Form
  2. DRS Enrollment Form_WC
  3. Position Eligibility Form
  4. PSERS EligibilityWorksheet
  5. DRS Plan Choice Booklet for Plans 2 and 3

Orientation - Health Insurance and Voluntary Benefits

  1. 01_Important Notice to New Employees
  2. 2021 REVISED Enrollment Guide - Whitman County - Non Rep
  3. 2021 REVISED Enrollment Guide - Whitman County - RBU
  4. 2021 REVISED Enrollment Guide - Whitman County - SWBU
  5. 2021 REVISED Enrollment Guide - Whitman County - Temporary
  6. 2021 Enrollment Guide - Whitman County - CBU
  7. 2021 Access PPO 1500 HSA Benefit Summary
  8. 2021-SBC-WCIF-Access-PPO-1500-HSA
  9. 2021 Access PPO 5000 Benefit Summary
  10. 2021-SBC-WCIF-Access-PPO-5000
  11. 2021 HMO 750 Benefit Summary
  12. 2021-SBC-WCIF-HMO-750
  13. 2021 Premera BC 500 Plan
  14. 2021 Delta Dental Plan D
  15. 2021 Willamette Dental High Plan
  16. 2021 VSP Standard Plan
  17. CBU Rate Sheet 2021
  18. COSS Rate Sheet 2021
  19. DSA Rate Sheet 2021
  20. Non-Rep Rate Sheet 2021
  21. SWBU Rate Sheet 2021
  22. RBU Rate Sheet 2021
  23. Temporary Rate Sheet 2021
  24. Life Flight application
  25. Group Voluntary Life Insurance
  26. Group Voluntary Short Term Disability Insurance
  27. The Standard Group Buy-up Long Term Disability Insurance - Booklet
  28. The Standard Group Voluntary Accidental Death and Dismemberment Insurance Booklet
  29. WHITMAN COUNTY BENEFIT PHONE NUMBER LIST 2021

Orientation - Public Works Employees Only

  1. CDL Manual
  2. CDL Manual Acknowledgement
  3. DRUG and ALCOHOL BACKGROUND CHECK - CDL
  4. PUBLIC WORKS - Whitman County Public Works - IT Devices
  5. PW cardholder agreement

Orientation - Union Documents

  1. NEW EMPLOYEE NOTIFICATION FORM_WC
  2. Teamster Unit Application
  3. Teamsters LIfe Insurance Beneficiary form
  4. Union Initiation Fee Deduction Authorization
  5. UNION Membership Choice form