Early Learning Coalition of NW Florida 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section I, where you will enter the employee's information. Fill in the name, Social Security Number (SSN), and address. Ensure accuracy as this information is crucial for eligibility determination.
3. Continue by indicating the date current employment began and whether the employee was previously employed. If applicable, provide the last day of employment.
4. Next, specify the employee’s annual salary and their pay rate—either hourly or daily. Select the appropriate pay schedule from weekly, bi-weekly, semi-monthly, monthly, or other.
5. In Section II, document the pay record for the six weeks prior to the specified end date. Include gross earnings, hours worked, and any tips received.
6. Finally, complete Section III with employer information. Ensure that all details are accurate and sign where indicated to confirm authenticity.

Start filling out your form today for free using our platform!