TST BOCES Consultant Contract: INTERNAL
Tompkins-Seneca-Tioga BOCES
555 Warren Road
Ithaca, NY 14850
Name *
(first and last)
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BOCES Contact for services to be provided *
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Address *
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City *
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State *
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Zip *
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Phone *
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Email: *
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I hereby agree to complete the following service(s) for TST BOCES. Description of services to be provided: *
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Description of consultant fees (hourly rate, discounted rate for multiple hours, etc.) and expenses.: *
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Declination of Retirement Benefits: If you are being hired by TST BOCES and not a school district, please fill out the information below.
By selecting "Not A Member", you have the following understandings:

I understand that I am not currently a member of the Teachers' / Employees' Retirement System.
I understand that I have a right to join the Teacher' / Employees' Retirement System.
I understand that part time employment (i.e. less than a full day, every day school is in session for the Teachers' Retirement System or anything less than full time, 12 month employment for the Employees' Retirement System) does not require that I join the Retirement System.

NOTE: Any employee who is eligible to join the Teachers' Retirement System and is hired during the school year full-time through June 30, or the last day school is in session, must join the Teachers' Retirement System. (Section 503- 1 Education Law)

Indicate your retirement status:
If you are a current member or retired member, please provide the following below: TRS or ERS, Your TRS/ERS retirement #, Tier, and date joined.:
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Esign Verification: Digital Signature *
Consultant Signature: *
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