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Feedback &

Request Forms

 

  

 
 
Date Posted Title Description
3/23/2010 2:22:17 PM Computer Training Request Complete this form to request computer or reporting training.
1/29/2010 11:08:41 AM Call Request
For computer or reporting assistance please complete information below. Someone will call you and provide assistance. We will attempt to return your call before your shift ends. Service is available 9:00am to 8:00pm. You can make requests at any time however. (If you do not have an email account use employee@choicesincl.com)
 
Program phone number. NOTE: We only call back work location numbers. A correct number to your work location must be entered or this request will be ignored.
7/23/2009 5:56:45 PM I Make A Difference Application
We know you make a differance. So tell us how! Provide a story or give examples of how you make a differance in the work you do. Your story could show up on choiceshr.com giving you the recognition you deserve.
7/23/2009 4:02:38 PM Premier Fitness Membership Sign Up

We are on a waitlist. Complete form below and you will be contacted by HR when a space is available.
Complete this form to begin payroll deduction (26 pays) for a 1 year membership to Premier Fitness.
 
The membership includes all workout facilities, pool use, all classes, child care (while using club) and tanning.
 
Submitting form indicates your approval of membership deductions from payroll. Membership ends if employment terminates. Memberships are limited, employees will be added to the waitlist once open slots are full. If you do not have an email account enter employee@choicesincl.comin the email field below.
12/2/2008 3:05:02 PM CICL 2010 Employee Benefit Selection Form
All full-time CICL or part-time employees hired before January 1, 2007 are required to complete this form to indicate their choice for how their annual benefit allowance will be utilized.
 
This form is to be completed even if your selection is to decline participation in all optional benefit coverages.  If you select to participate in any of the optional coverages, you will be required to complete the appropriate enrollment form.  If this applies to you, please select the appropriate enrollment form from the "Feedback/Request Forms" section at the ChoicesHR.com website.
 
If you have any questions, or would like to request a hardcopy of the form, contact Human Resources at 937/898-2220.
 
 
12/1/2008 2:59:43 PM 2010 Flex Spending Enrollment
This is an enrollment option for you to enroll in the Chard-Snyder Flexible Spending Account (FSA) for the 2009 calendar year.  If you would like to complete a hardcopy of the enrollment form, contact Human Resources.  The following is a description of the different options that an employee can select.
 
                                      Plan Election Description
 
Healthcare - Flexible Spending Account (FSA):  This is a pre-tax contribution that you make equal installment from each pay to reach the total amount you have selected.  This account is used to cover out-of-pocket expenses for medical, dental, and vision related expenses.  The total maximum amount that can be contributed annually is $3,500.00.
 
Dependent Care - Flexible Spending Account (FSA):  This is a pre-tax contribution that you make equal installment from each pay to reach the total amount you have selected.  This account is used to cover out-of-pocket expenses for child care or adult daycare expenses.  The total maximum amount that can be contributed annually is $5,000.00 if you are married filing jointly or single.  If you are married and filing separately, the maximum annual amount you can contribute is $2,500.00.
 
Debit Card:  The "Benny" prepaid benefits card is available for use for the Healthcare FSA. 
 
 
11/29/2008 11:58:37 AM Superior Dental 2010 Enrollment
This is an enrollment option for you to select dental insurance for you and your family.  If you would like to complete a hardcopy of the enrollment form, or you have questions or concerns, contact Human Resources. 
11/29/2008 11:35:57 AM Long Term Disability Coverage 2010 Enrollment
This is an enrollment option for you to select additional long term disability insurance for you.  If you would like to complete a hardcopy of the enrollment form, or you have questions or concerns, contact Human Resources. 
11/29/2008 10:39:52 AM UNUM Term Life Enrollment Form 2010
This is an enrollment option for you to select additional term life insurance for you and your family.  If you would like to complete a hardcopy of the enrollment form, or you have questions or concerns, contact Human Resources at 937/898-2220. 
4/24/2008 10:28:56 AM Unusual Incident Report Unusual Incident Report
3/1/2008 Request for Educational Allowance Reimbursement Request for Educational Allowance Reimbursement
3/1/2008 Request for Leave of Absence Request for Leave of Absence
3/1/2008 Personnel Action Form (PAF) Personnel Action Form (PAF)
3/1/2008 Request for Transfer Request for Transfer
3/1/2008 Finders's Fee Request Finder's Fee Request
3/1/2008 Job Posting Request Job Posting Request
3/1/2008 Employee Service Award 2010

The Recognition Committee is accepting nominations for the 2010 Employee Service Award. Employees or clients of CICL may nominate an employee for the recognition. Please submit your nomination to Human Resources by September 3, 2010. As a part of your nomination, please provide a brief statement why you believe that the employee should receive the award. The purpose of the award is to recognize employees and their actions that have helped make Choices In Community Living a better place for co-workers and /or clients.

 

If you would like to complete the actual form, you can request one from your supervisor. But feel free to complete your nomination by email or on-line and submit it to Human Resources by September 3, 2010  for consideration. If you would like to remain anonymous, we understand, but that will require you to complete the actual form versus using the email or on-line options.

Remember, the submission deadline is September 3, 2010.

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