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Central Lyon CSD



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FORMS & More!

2020-2021 Insurance Rates_ Certified Staff
2020-2021 Insurance Rates _ Classified Staff

If you are currently enrolled in the district's WELLMARK Health Plan, but want to change plans, please complete 
    Wellmark 2020-2021 Current Enrollment & Waiver

If you are not enrollment in the district's WELLMARK Health Plan, but wish to enroll, please complete
    Wellmark Health Insurance Application

If you have any changes to your personal information OR want to cancel a family member from coverage, please complete
    Wellmark Change Form


WELLMARK Benefit Summary of Benefits

Wellmark $1000 Deductible Summary of Benefits

Wellmark $2000 Deductible Summary of Benefits

Wellmark $5000 Deductible Summary of Benefits

Lincoln Financial At-A-Glance _ Life & ADD Insurance

Lincoln Financial Enrollment Form

Avesis Vision Summary of Benefits

Avesis Vision Enrollment Form

Delta Dental At-A-Glance Booklet

Delta Dental Enrollment Form






Master Contract 2019-2021

Certified Handbook (previous Master Contract language)

Classified Benefits Summary

Family Medical Leave Act
FMLA Additional Information
Central Lyon Policy 409.3, pages 8-35 ~ https://www.centrallyon.org/vimages/shared/vnews/stories/4832dfb304db0/SERIES%20400%20-%20EMPLOYEES%20%28407.4%20-%20415.0A%29.pdf

Direct Deposit Authorization


IRS I-9 form

IRS W-9 form

Federal IRS W4 Form _ 2020

State of Iowa IRS W4 Form _ 2020


The Central Lyon Community School District offers career and technical programs in the following areas of study: Business Education, Family & Consumer Sciences Education, Industrial Arts Education and Vocation Agriculture Education. It is the policy of the Central Lyon Community School District not to discriminate on the basis of race, color, national origin, sex, disability, religion, creed, age (for employment), marital status (for programs), sexual orientation, gender identity and socioeconomic status (for programs) in its educational programs and its employment practices. Inquiries or grievances may be directed to the Superintendent, Central Lyon CSD, 1010 S. Greene St., Rock Rapids, IA 51246, (712) 472-2664, superintendent@centrallyon.org. Please see District Board Policies for additional information on grievance procedures.