Many benefit enrollments and other  transactions are completed electronically via secure websites.  A few transactions require completion of one of the forms shown below.  Contact Human Resources if you're unable to locate a form or need help. Since forms change from time to time as plan provisions are revised,  you should only print copies to take care of your immediate need.

Benefits Forms

Tuition Benefit Forms Tuition Remission Application Form
Tuition Exchange or Fachex - New for 2017-18!  Apply online at
Tuition Reimbursement Request 
Leave of Absence Forms

Leave Request Form for Medical Reasons
Non-Medical Leave of Absence Request
DOL Physician's statement  
DOL Physician's Statement Family Member   
DOL Physician's Statement-Current Military 
DOL Physician's Statement-Caregiver of Military Veteran 
DOL Military Certification of Qualifying Exigency 
Community Service Leave Request Form

Other HR Forms

Change of Address/Name Change of Address/Name Form
Supplemental Pay Request Form Staff Supplemental Pay Request Form
Request for Title & Department Change Request for Title & Department Change
Volunteer Acknowledgment Forms Volunteer Acknowledgment Form
Wage Change Form
Honored Retiree Nomination Forms

Honored Retiree Nomination Form

Honored Retiree Policy

Honored Retiree Benefits

Payroll Forms

Go to Payroll Forms, for:

  • W-4 tax withholding
  • Payroll advance requests
  • Exempt & Librarian Leave Reports
  • W-9 Request for Taxpayer ID
  • Other pay related requests
Direct Deposit is mandatory.  To initiate or change your direct deposit, complete the Direct Deposit Form For Faculty and Staff  
Safety Forms  
Safety Orientation