LISD

ONE-TIME COVID-19 VACCINATION STIPEND EMPLOYEE ACKNOWLEDGEMENT and CONSENT FORM for
NON-EMPLOYEES ONLY!

IF YOU ARE AN EMPLOYEE OF THE DISTRICT, YOU MUST FILL OUT YOUR FORM IN SKYWARD.

IF YOU HAVE A SKYWARD LOGIN, YOU MUST FILL OUT YOUR FORM IN SKYWARD.


The Longview Independent School District is offering a one-time $1000 COVID-19 Vaccination Stipend to District employees who voluntarily choose to be fully vaccinated against COVID-19. The incentive will be available through November 1, 2021. To be eligible, employees must submit proof of full vaccination status by November 1, 2021 and remain employed with the District through completion of the 2021-2022 school year. Pfizer-BioNTech, Moderna or Johnson & Johnson are acceptable vaccinations. Any CDC-issued vaccination card is acceptable. If you have lost your card, contact your vaccination provider or local health department.


For all eligible employees other than substitutes, custodians, and part-time employees, payment of the COVID-19 Vaccination Stipend will be in the amount of $1000 and shall be distributed and included in the employee's November 2021 paycheck. Payment for substitutes will be made in two increments, one in the November 2021 paycheck in the amount of $250. Substitutes will earn an additional $250 for every 25 full days of work up to 75 days of work. Final payment will be made in May 2022. Payment for part-time employees and custodians will be made in two increments, one in the November 2021 paycheck and the other in May 2022.


District employees who are unable to receive the vaccine due to their disability or religious beliefs shall be eligible to receive the one-time COVID 19 Vaccination Stipend, payable in May of 2022 upon proof of eligibility for exemption and weekly COVID testing at the Longview ISD Educational Support Center.