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Click ‘Get Form’ to open the Leslie Benefit Kelly Services form in the editor.
Begin by entering your personal information in the designated fields, including your name, Social Security Number, address, and contact details. Ensure accuracy for seamless processing.
Fill out the sections regarding your spouse and children if applicable. Provide their names, ages, birth dates, and Social Security Numbers as required.
Select your desired insurance plans by checking the appropriate boxes for Group Term Life Insurance, Short Term Disability Income Plan, Dental Plan, Vision Care Plan, and Accident Insurance. Review the monthly premiums associated with each option.
Complete the billing preference section by choosing between Monthly Direct Billing or Bank Draft Authorization. Make sure to include any necessary payment details.
Finally, review all entered information for accuracy before signing and dating the form at the bottom. This ensures that your application is complete and ready for submission.
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Job Specific Qualifications: As a Kelly employee, youll
Transportation Spending Accounts (offered and administered by Leslie Associates - these plans are not sponsored by Kelly Services). Page 2. Please noteRead more
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