Enrollment for the Sick Leave and Maternity Leave Banks is OPEN.
Contact Charmaine Wilks at 202 517-1475 or at cwilks@wtulocal6.net to enroll or with any questions. Open enrollment will occur from June 1, 2023 through August 31, 2023.

This is strictly for the use of the Sick Leave and Maternity/Paternity Leave Banks and not the Dental/Vision enrollment.
Sign in to Google to save your progress. Learn more
Email *
DCPS Employee ID *
Last Name *
First Name *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Country *
Street Address 1 *
Street Address 2
City *
State *
Zip Code / Postal Code *
Home Phone *
Cell Phone *
Location / School *
Date of Employment *
MM
/
DD
/
YYYY
Status Classification *
Bank *
Job Title *
Required
 Date of Enrollment In the Bank(s) *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy