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Forms

​Benefits Forms

  1. Carrier Change Form
  2. Change of Name/Address Notification
  3. College Release Program and Staff Education Reimbursement Request
  4. Family Medical Leave/Parental Leave Request
  5. FMLA Authorization for the release of medical information
  6. FMLA Certification of Health Care Provider for Employee
  7. FMLA Certification of Health Care Provider for Family Member​
  8. FMLA Certification of Qualifying Exigency for Military Family Leave
  9. FMLA Certification for Serious Injury of Covered Servicemember - Caregiver Leave
  10. Fitness Release Time Application
  11. Fitness Release Time PAR-Q Form
  12. Health Risk Assessment and Physical Exam Incentive
  13. Lactation Accommodation Request​  
  14. Medical Inquiry Form​​
  15. Optional Retirement Plan Termination Notice
  16. Optional Retirement Program Certification 
  17. Request for Workplace Accommodation​
  18. Salary Reduction Agreement (ORP & TDA)
  19. Sick Leave Pool Contribution/Withdrawal Request
  20. Sick Leave Direct Donation - Donor Form
  21. Sick Leave Direct Donation - Recipient Form
  22. The Edge (Staff Council Form)

Workers' Compensation Forms

  1. Authorization for Release of Information (SORM-16)
  2. Employee's Election Regarding Utilization of Sick and Annual Leave (SORM-80)
  3. Employee's Report of Injury (SORM-29)
  4. Witness Statement (SORM-74)
  5. Supervisor Report of Accident

EEO Forms

  1. Veterans Status Questionnaire​​​

Talent Acquisition Forms​​​​​​

  1. Consulting and Paid Professional Service Application Form (for faculty and staff working a second job)
  2. Drug and Alcohol Abuse Prevention Statement
  3. Emergency Evacuation Assistance Form
  4. External Job Posting Template (faculty only)
  5. ​Faculty Credential Form
  6. Fair Credit Reporting Act
  7. Internal Employment Request Form
  8. Interview Request for Faculty Candidate
  9. Interview Request for Professional Staff Candidate
  10. Job Offer Request Form
  11. Motor Vehicle Record Evaluation Request
  12. New Employee Orientation Survey
  13. Notice of Terms of Initial Appointment
  14. Personnel Recommendation
  15. Required Documents for New Employees
  16. Search Committee Nomination Form
  17. Security Sensitive Position Questionnaire
  18. Student Assistant Job Announcement Form
  19. Taleo Adjunct Requisition Template
  20. Taleo Non-Tenure Track Requisition Template
  21. Taleo Tenure Track Requisition Template
  22. Taleo Staff Requisition Template
  23. Student Worker Statement of FERPA Understanding
  24. Voluntary Modification of Employment (VMOE) Application
  25. Staff Advertising Options

Payroll Forms

  1. Advance Authorization for Overtime
  2. Direct Deposit Authorization 
  3. Employment Classification Checklist
  4. ePOI Application Form
  5. Multiple Direct Deposit Supplemental Form
  6. Pay Option Form 
  7. Prior State Service Form
  8. Request for Additional Compensation
  9. Time and Effort Adjustment Request
  10. TRAM Biweekly Schedule Template
  11. W4
  12. 9.2 Work Group Request Template​​

Compensation Forms

  1. Career Ladder Job Change Request
  2. Employment Classification Checklist
  3. Job Analysis Questionnaire (JAQ)​​​
  4. Total Compensation Analysis

Progressive Disciplinary Forms

Prior approval from ESO is required for forms # 2 through # 7

  1. Notice of Verbal Counseling 
  2. Employee Written Reprimand
  3. Notice of Suspension Without Pay
  4. Notice of Dismissal from Employment
  5. Notice of Probationary Dismissal from Employment
  6. Performance Improvement Plan (PIP)
  7. PIP Progress Assessment
  8. PIP Progress Assessment Instructions

General Forms

  1. UHD Adroit Job Order Requisition
  2. Business Use Only Verification
  3. Communication Stipend Request​
  4. Complaint Form
  5. Department Dress Code Form
  6. Gas Card Agreement-Fleet
  7. HRIS Security Access Request​
  8. Media Release Form
  9. Moving and Relocation Expense Form​
  10. Staff Dress Code Statement
  11. Staff Grievance Intake and Resolution Form

Separation/Exit Forms

  1. Separation Clearance Process
  2. Separation Survey​

One or more documents on this site are in PDF format. In order to view and print these document(s), you will need the Adobe Acrobat Reader software. It can be downloaded from the Adobe website.

Last updated 1/15/2020 4:56 AM