HR Forms

General Forms

• Non-FMLA Leave Request
• Non-FMLA Sick Leave Bank Request Form
• Incident/Injury/Illness Report
• Employee Change of Name

Benefit Forms

• Benefit Election Form – Facilities, University Faculty, Non-Aligned, PSSA, Public Safety, SOL
• Benefit Election Form – Adjunct Faculty
• Benefit Election Form – Dining
• Blue Cross Application
• Prime Reimbursement Form
• Prime Prescription Order Form
• Delta Dental Application
• FSA Enrollment Form
• VSP Enrollment Form
• VSP Member Reimbursement Form
• Lincoln Financial Life Insurance Enrollment Form
• Lincoln Financial Beneficiary Designation Form
• 403b Salary Reduction Agreement (Non-Faculty and School of Law)
• 403b Salary Reduction Agreement (University Faculty)
• FSA & HRA Claim Reimbursement Form
• FSA Dependent Care Provider Letter (Sample)
• FSA - ACH Direct Deposit Form

Employment Forms

• Self-Identification for Protected Veterans
• Self-Identification of Disability
• Employee Annual Self-Evaluation
• Employee Annual Performance Evaluation
• Interview Evaluation
• Personnel Action Form - Staff (PAF)
• Personnel Action Form - Faculty (PAF)
• Reference Check Form
• Volunteer Questionnaire
• Intern Questionnaire

Tuition Programs

• CIC Application
• Tuition Refund Application
• TE and CIC-TEP Information Procedures
• Tuition Exchange List of Schools