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Houston Independent School District Supplemental Sick Leave Bank SSLB 2015-2016 Membership Enrollment and Termination Form Form must be received by the end of the open enrollment period on May 29 2015 Employee Name Last First Middle Employee ID Number XXX-XX- Phone Number Job Title Position Last 4 SSN Months Worked Per Year 10 10. Membership Termination Please cancel my SSLB membership for the 2015-2016 plan year. I understand the local personal leave day s I have contributed to the SSLB are...
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