Intake Form: Supporting Student Gender Identity 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Employee Information' section. Enter your name, effective date of change, and employee ID number accurately.
3. Indicate if you are currently listed as a dependent under another MCPS employee’s benefit plan by selecting 'Yes' or 'No'. If applicable, provide the employee ID of that person.
4. In the 'Changes' section, specify any corrections needed. For example, if changing your date of birth, enter the new date and attach a copy of your birth certificate or valid driver’s license.
5. If you need to change your name, type or print your former name above and provide the new name. Attach any necessary legal documents such as a marriage certificate or divorce decree.
6. For changes to your Social Security number, enter the new number and attach a copy of your Social Security card.
7. Finally, sign and date the form in the designated area before submitting it to the Employee and Retiree Service Center (ERSC).

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