Follow updates on the City's Response to COVID-19 | Visit the Burlington COVID-19 Resource and Recovery Center
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Human Resources Forms & Information
COVID-19 City of Burlington Employee Forms and Information
- Emergency Leave Policy
- Emergency Leave Request Form
- Families First Coronavirus Response Act (FFCRA) Expanded Family & Medical Leave FAQ
- FFCRA Employee Rights Poster
- Protocols for COB COVID-19 Positive Cases
- Cloth Face Covering Policy
- COVID-19 Coronavirus EAP Managing the Challenges During the Holidays
- COVID-19 Coronavirus EAP Celebrating Holidays During the Pandemic
Application Materials
- Application for Employment (Word Document)
- Application for Employment (PDF)
- 2019-2020 BFD Hiring Process V1
Basic Employment Forms
- I-9 Form
- 2020 W-4
- Declaration of Health Care
- Employee Change of Status form
- Employee Personal Information Questionnare
Comprehensive Personnel Policy Manual
Contracts
Dental Insurance Forms
Domestic Partner Enrollment Forms
ICMA Forms
Flexible Spending & DCAP Forms
Parental, Medical, or Family Form
Health Insurance / Prescription
- Cigna Medical Health Insurance Form
- Cigna Medical Health Health Plan Summary
- COBRA Continuation Notice
- Notice of HIPAA Privacy Practices
- Affordable Care Act Marketplace Notice
- Health Insurance Buyout Form
- CanaRx BurlingtonMeds
Miscellaneous HR Materials
- Holiday List 2020
- Holiday List 2021
- Livable Wage Notice 2020
- Livable Wage Ordinance 2020
- Reasonable Suspicion Checklist
- Reasonable Suspicion Training Frequently Asked Questions
- Sustainability Presentation
- Gym Membership Agreement
Nationwide Enrollment Form
