Forms and Documents Staff

Aeries User AgreementAeries Use Agreement
Change RequestComplete this form and submit to the District Office if you have any changes. It is important that your current contact information and name are accurate in our records.
Classified Long Term DisabilityInformation on Disability
Complaint Form English | SpanishGeneral complaint form against an employee of the district. Please submit to the district office.
Employee Assistance ProgramEmployee Assistance Program – Anthem Blue Cross
Employee ReimbursementsInformation on Employee Reimbursements
Facility Use Board PolicyFacilities Use Board Policy
Facility Use FormForm for requesting the use of a School district facilities for an event. Please submit the form to the district office once proper approval has been obtained from the site. The Governing Board recognizes that district facilities and grounds are a community resource and authorizes their use by community groups for purposes provided for in the Civic Center Act when such use does not interfere with school activities.All school-related activities shall be given priority in the use of facilities and grounds under the Civic Center Act. Thereafter, the use shall be on a first-come, first-served basis.
Facilities Use Form (District Office Use)Form for requesting the use of the District Office building for an event. Please submit the completed form to the district office for further processing.
Family & Medical Leave Act Employee Rights and Responsibilities
Field Trip Request FormInitiate a field trip request.
Frequently Used AcronymsA List of Acronyms that are used frequently within the District.
Hiring RequestThis form is specifically for Administrators.
In-House Job ApplicationCurrent Konocti Unified School District Employees may use this convenient online application to apply for current vacancies listed on for which a transfer/reassignment request was NOT submitted prior to April 1st. Please submit a separate application for each position you are interested in. Applications must be received by 12:00 (noon) on the close date listed.
LeavesThe following is a list of Leave Forms/Information:
FMLA Rights & Responsibilities
FMLA Absence Request Form
KEA Bargaining Agreement: Article VIII – Leaves
KPA Bargaining Agreement: Article VI – Leaves
CSEA Bargaining Agreement: Article III – Leaves
Letter of Resignation/Retirement FormInternal form for submitting a resignation or retirement request.
Moving/Relocation ReimbursementThe Board of Trustees for Konocti Unified School District has approved a moving/relocation reimbursement for Designated Staff that become employees of the District up to $2000. The information provided includes criteria for who is eligible to submit reimbursement and what expenses are eligible for reimbursement.
Notice of Intent to Advance on Salary ScheduleThis form must be submitted by June 1st to take effect the following school year. (Please submit a separate form for each institution.)
Notice to Employees
Workers Compensation
Physician Predesignation English | SpanishWorkers Compensation
Position Advertising RequestRequest to advertise an open position within a department or school. Please submit to the district office.
Position Control Request FormThis form is specifically for Administrators.
Report of LossIf an incident occurs in which damage to property or personal injury is involved, please immediately notify the District Office. Complete this report in its entirety and send to the district office within two days of the incident. District office staff will report to the district’s insurance company if appropriate.
Supervisor’s Report of Employee InjuryForm for an administrator to complete for an employee injury.
Tax Withholding Forms Federal (W-4) | State (DE4)Tax Withholding Forms for Employees
Transfer RequestComplete this form if you wish to transfer positions within the District. *Note: this form can only be used and submitted to the District Office by May 1st of the current school year.
Uniform Complaint Procedures and Policy English | SpanishThe following procedures shall be used to address all complaints which allege that the district has violated federal or state laws or regulations governing educational programs. Please review the procedures provided on the left, and complete the form and submit it to the District Office.
Williams Uniform Complaint Form English | SpanishEducation Code 35186 creates a procedure for filing of complaints concerning deficiencies in instructional materials, teacher vacancy or misassignment, maintenance of facilities, and CAHSEE Prep. The following form contains elements required by Education Code 35186. You may return this form to your child’s school.
Workers Compensation Benefit SummaryWorkers Compensation


Request for Proposals

Please click the link for Request for Proposal No. 2019-01: rfp-2019-01 ...

Community Christmas Celebration sponsored by Rotary of Clearlake

Join Rotary of Clearlake on Saturday, December 14th for a community Christmas celebration from 10am to 2pm at Burns Valley School. Special Guest.... ...

Lights on After School Celebration

  Pomo after school program celebrated Lights on After School with a western themed performance, decorations and food. Launched in October 2000, Lights On After school is ...

Food Service Surveys

High School Cafeteria Survey: Elementary School Cafeteria Survey: ...

View All Recent News >>

Upcoming Events