Senate Page and Messenger Forms

All forms are in Portable Document Format (PDF) and contain fields in which requested information should be typed. Please make every effort to type your information into as many fields as possible to expedite processing. Forms must be completed and submitted by December 7, 2012. Please return ALL forms in a timely manner to expedite final processing.

To read and print the forms, you must have Adobe Acrobat Reader software installed on your computer. You may also download the Adobe Acrobat Reader version suitable for your system.

I. PROGRAM HANDBOOK (1 form)

1. Program Handbook (Note: You are required to bring one copy of the Handbook with you to Orientation). Please read the handbook and discuss our expectations with your family. Guidelines, Rules and Policies Form (Handbook Form 1 of 1)

II. EMPLOYMENT FORMS (5 forms)

Instructions for Employment Forms (please read these instructions carefully)

2a. Federal W-4 (Employment Form 1 of 5)

2b.State VA-4 (Employment Form 2 of 5)

2c. Employment Eligibility Verification I-9 (Employment Form 3 of 5)

2d. Employee Direct Deposit Authorization (Employment Form 4 of 5)

2e. Senate Page Direct Deposit Authorization (Employment Form 5 of 5)

III. HOUSING FORM (1 forms)

3. Omni Hotel Swimming Pool Waiver (Housing Form 1 of 1 must be notarized)

IV. MEDICAL FORMS (6 forms)

4a. Medical Release (Medical Form 1 of 6 must be notarized)

4b. School Entrance Health Form (Medical Form 2 of 6; it must be completed by your physician. A physical exam is not required for employment. Please note date of flu shot)

4c. Consent to Accompany Minor Patient (Medical Form 3 of 6)

4d. Conditions of Healthcare Services (Medical Form 4 of 6; please include a copy of your health insurance card)

4e. Pediatric New Patient Questionnaire (Medical Form 5 of 6)

4f. Allergy Form (Medical Form 6 of 6)

To return your completed forms electronically (preferred)

Please download the forms to your computer, type in all requested information, print, and sign all forms.
Review your forms, check for errors.
Electronically scan your forms to return via e-mail.
E-mail your completed forms as PDFs to information@senate.virginia.gov
Please do not return forms in .jpeg, .gif, or.tiff file formats.

To return your completed forms via U.S. mail

Please download the forms to your computer, type in all requested information, print, and sign all forms.
Review your forms, and check for errors.
Place your completed forms in one envelope addressed to:

Senate Clerks Office
P.O. Box 396
Richmond, Virginia 23218

Forms must be completed and submitted by December 7, 2012.
Please return ALL forms in a timely manner to expedite final processing.