Request for Longevity Pay SY26-27

Please fill out this form when you are eligible for longevity pay based on the terms of your employment or collective bargaining agreement.

This form should be used for the 26-27 School Year.

Your First Name*

Answer required for "Your First Name"

Your Last Name*

Answer required for "Your Last Name"

Your Employee ID Number

Answer required for "Your Employee ID Number"

Your Position*

Answer required for "Your Position"

Teacher

Administrative Assistant

Paraprofessional

Administrator

Other

Your Union

Answer required for "Your Union"

Unit A

Unit B

Unit C

Unit D

Other

Number of Employed Years You Have Completed With EPS*

Answer required for "Number of Employed Years You Have Completed With EPS"

40-Plus

I hereby attest that this information is true, accurate, and complete to the best of my knowledge.*

Answer required for "I hereby attest that this information is true, accurate, and complete to the best of my knowledge."

Yes

Please fix the highlighted areas below before submitting.