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Form Descriptions and Forms in Adobe Acrobat Format

The following forms for Town employees are presented in Adobe PDF format, click here if you need to download the Adobe Acrobat Reader.

A B C D E F G H I J K L M N P Q R S T U V W X Y Z

Click on the Form Title to view the appropriate form.
Form Title
Form Title

ADA Action Request 1.4-1
ADA Accomod Req 1.14-2
Agenda Form 1.16-1
AED W.M.Checklist 1.16-1
AED Use Report 1.16-2
Accident Forms 2.24
Annual Leave Payment 2.9-4

 Blood Path CFR 29 1910-1030
Branch Road Tot Lot Inspection Form

Catastrophic Sick Leave 2.95
CDL Empl Agreement 2.34-1
CDL Records Release 2.34-2
Cell Phone Reimb 2.40-2
Civilian Supervisor Eval Form 2.16-1
Classified Service Eval Form 2.16-2
Code of VA 32.1-45.1
Code of VA 32.1-45.2
Colonial Claim Form
Conditional Offer PD 2.5-8
Conditional Offer - Civilian 2.35 and 2.4-2
Confined Spaces Entry Permit
Criminal Hist Compl 2.3-1

Direct Deposit
Disciplinary Action Form
Driving Record Release 2.4-2

Employee Language Translators List
Employee Separation From Service
Essential Job Function - Police 2.5-3
Exit Interview

Family Medical Leave
Fitness Log
Flex-Time Form
Flexible Benefits Claim Form
Flexible Benefits Direct Deposit Form
Flexible Spending Enrollment Form
Flexible Benefits Eligible Expenses
Flexible Benefits Web Directions
FOI 3.0

Glyndon Inspection Form
Grievance Form A 2.18
 Grievance Form B 2.18-2
Hepatitis B Vaccine Consent
Hepatitis B Vaccine Election

Impaired Perf Rpt 2.20-2
Infectious Disease Exposure Form
Instructor Evaluation Form 2.16-3R
Interview Form
Investigation Report SB-3
Investigator Evaluation Form 2.16-5

Lawful Questions 2.3-3
Leave Donation Contribution 2.9-1
Leave Donation Request 2.9-2
Light Duty Form
LWOP Request 2.9-3

Meadow Lane Inspection Form
Mgmt and Admin Evaluation Form 2.16-4
Modified Duty Work Form

Notary Log Form

Officers Interview Questions 2.5-7 - not available online
Open End Quest 2.3-4
Overflow Report SB-4

PD Supervisor Eval Form 2.16-7
Permission to Enter
Personal Reference 2.5-5
Personal Info Release PD 2.5-6
Peterson Lane Inspection Form
Police Officer Eval Form 2.16-6
Position Requisition
Post Exposure Evaluation
Process Summary 2.5-1
Public Facilities Checklist

Questions Not Ask 2.3-2

Record of Employee Counseling
Recreation Worker Performance Appraisal
Range officer physical
Release of Personal Info 2.4-2
Respirator Training Certification Form
Retiree Health Insurance 2.19-1

Seasonal Evaluation Form 2.16
Service Recog Group Form 2.28
Service Recog Individual Form 2.28
Sewer Backup Information SB-2
Southside Park Inspection Form
Suggestion Form 2.28-1
Substance screen request 2.20-3
Sustance Abuse Checklist 2.20-1

Telephone Screening Police AS 2.5-2
Town Notaries
Town Green
Travel Authorization 6.0

UHC - How to read your EOB form
UHC - Medical Claim form
UHC - Pharmacy Claim form

Water and Sewer Inspections
Wellness Release & Waiv 2.41-1
Withholding: Federal Taxes
Withholding: DC and Federal Taxes
Withholding: MD and Federal Taxes
Withholding: VA and Federal Taxes
Withholding: WV and Federal Taxes
Work Experience (Police) 2.5-4
Workers Compensation 2.23
Workplace Inspection Checklist