Human Resources

BAINBRIDGE COLLEGE

FORMS

Employment Forms:

• Application (BC Application.pdf)
• W-4 – Federal Withholding (W-4.pdf)
• G-4 – State Withholding (G-4.pdf)

Dental Insurance Forms:

• Dental Plan Summary (Indemnity Dental.pdf)
• Dental Benefits Claim Form (Dental Claim.pdf)

Health Insurance Forms:

• Indemnity Plan Book (Indemnity Plan Booklet.pdf)
• Indemnity Health Benefits Claim Form (Health Claim.pdf)
• Pharmacy Benefits Claim Form (Pharmacy Claim.pdf)
• PPO-Indemnity Comparison Chart (PPO-Indemnity Comparison.pdf)
• Request for Reimbursement of Dependent Care expenses
• Request for reimbursement of health care expenses

Retirement Forms:

• Teachers Retirement System of Georgia Member’s Guide (Teachers Retirement Guide.pdf)

Other Forms

• Authorization for Payroll Direct Deposit
• Change of Address