Human Resources – Forms

I. Frequently Used Forms

Change of Name/Address/Emergency Contact Form – All Employees – Fillable PDF Form

Comp Time Form for Management & SUOAF Employees

Direct Deposit Authorization Form

Disbursement Form for Searches

Disclosure of Home Address & Emergency Contact Form

Dual Employment Form

Employee Request for Compensation For Activities Form

Emergency Room Copayment Waiver Request – NEW 01-2018

Food Service Request Form

Overtime Form for FLSA Staff (non-SUOAF employees)

Overtime Form for FLSA SUOAF Employees

Position Action Form (PAF) – Contact HR for this form

Position Reclassification Request Form

Semester Employee Recognition Award Nomination Form

Tax Form: CT State W4-2018

Tax Form: Federal W4-2018

Tuition Reimbursement Form (A&R, Maintenance & Clerical Staff)

Tuition Waiver Form (Clerical Staff)

Tuition Waiver Form (Management/Confidential, SUOAF & AAUP Staff)

Tuition Waiver – MFA-Writing Courses Guidelines

Tuition Waiver – Graduate Courses – Job-Related Questionnaire (Mgmt/Conf, SUOAF, AAUP)

University Property Checklist Form

Welcoming New Staff Checklist

Work Schedule Form

II. Retirement Forms

Full Time Employees:

Change of Name/Address/Emergency Contact Form – All Employees – Fillable PDF Form

Part Time Adjuncts:

Change of Name/Address/Emergency Contact Form – All Employees – Fillable PDF Form

III. Evaluation Forms

Evaluation Form for A&R Staff

Evaluation Form for Clerical Staff

Evaluation Form for Maintenance Staff

Evaluation Form for Police Staff

Evaluation Form for Administrative Faculty (SUOAF) Staff

Evaluation Form for Confidential Unclassified Staff

Evaluation Form for AAUP Teaching Faculty

Evaluation Form for AAUP Counselors

Evaluation Form for AAUP Librarians

Evaluation Form for AAUP Athletic Coaches

Evaluation Form for AAUP Athletic Trainers

IV. Leave Related Forms

FMLA – General Letter – Statewide Policy

FMLA – Medical Certificate – P33A

FMLA – Employee Request – HR1 – REVISED 03/2018

FMLA – Notice of Eligibility, Rights & Responsibilities – HR2a – REVISED 03/2018

FMLA – Designation Notice – HR2b – REVISED 03/2018

FMLA – Core-CT Coding – HR2c – REVISED 03/2018

FMLA – Intent to Return to Work – HR3 – REVISED 03/2018

Sick Leave Bank Application (SUOAF Staff)

Sick Leave Bank Application (Management/Confidential & AAUP Staff)

State of Connecticut Voluntary Schedule Reduction Program Agreement Form

Student Employee & University Assistants – Medical Certificate – P33a

V. Employment Forms

Background Check Consent Form – Fillable PDF Form

Background Check SSA Consent Form – For Graduate Assistant & Student Employees Only – – Fillable PDF Form

Criminal Convictions Form – Addendum to Application of Employment – Fillable PDF Form

Employment Application – WCSU Employment Application – Fillable PDF Form

Employment Eligibility Verification – Form I-9 – Fillable PDF Form

I-9 Form – List of Acceptable Documents

IPEDS – Race/Ethnicity IPED Survey Form – Fillable PDF Form

Health Insurance Enrollment Form – Fillable PDF Form

Health Enhancement Program Enrollment Form (CO-1314) – Fillable PDF Form

New Hire Data Sheet for Graduate Assistants

New Hire Data Sheet for Student Workers – Contact HR for this form

New Hire Data Sheet for Lecturers – Fillable PDF Form

New Hire Data Sheet for University Assistants – Fillable PDF Form

Position Action Form (formerly Personnel Requisition Form) – Contact HR for this form

Part-Time AAUP Adjunct/Lecturer Teaching Forms – Contact HR for these forms

Records Retention and Disposition Policy Acknowledgement of Receipt – Fillable PDF Form

Retirement – Designation of Retirement Plan Election – Higher Ed Form (CO-931h – rev. 9/17) – Fillable PDF Form

Retirement – Designation of Retirement Plan Beneficiary Form (CO-999 – rev 9/17) – Fillable PDF Form

Retiree Health Fund (CO-1300) Form – Fillable PDF Form

Student Employee Appointment Authorization Form

Tax Form: CT State W4-2018

Tax Form: Federal W4-2018

University Assistant Recommendation for Hiring Form – contact Peggy Boyle in HR for this form

Voluntary Schedule Reduction Program – Request for Schedule Change Form – CT-HR-7c

Volunteer Athletic Coach Hiring Procedures & Request Form – Fillable PDF Form

Volunteer Hiring Procedures & Request Form – Fillable PDF Form

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