Human Resources – Forms
Frequently Used Forms
AAUP – Article 10.6.2 Administrative Assignment Payment Form – REVISED 11-2018
AAUP – Adjunct Non-Instructional Assignment Payment Form – REVISED 11-2018
AAUP – Faculty Consulting & Research with Public or Private Entities Compliance Form
Candidate Reimbursement Form – REVISED 01-2019
Change of Name/Address/Emergency Contact Form – All Employees – Fillable PDF Form
Direct Deposit Authorization Form
Disbursement Form for Searches
Disclosure of Home Address & Emergency Contact Form
Employee Request for Compensation For Activities Form – REVISED 12-2018
Emergency Room Copayment Waiver Request
Position Action Form (PAF) – Contact HR for this form
Position Reclassification Request Form
Tax Form: CT State W4-2019 – Link to: Connecticut Withholding Calculator
Tax Form: Federal W4-2019 – Link to: Federal Withholding Calculator
Tuition Reimbursement Form – A&R, Maintenance & Clerical Staff
Tuition Waiver Form – Clerical Staff
Tuition Waiver Form – Management/Confidential, SUOAF & AAUP Staff – REVISED 05-2019
Tuition Waiver – MFA-Writing Courses Guidelines
Tuition Waiver – Graduate Courses – Job-Related Questionnaire – Mgmt/Conf, SUOAF, AAUP
University Separation Checklist Form – REVISED 05-2019
University Exit Interview Questionnaire
Retirement Forms
Full Time Employees:
Change of Name/Address/Emergency Contact Form – All Employees
Part Time Adjuncts:
Change of Name/Address/Emergency Contact Form – All Employees
Evaluation Forms
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
Leave Related Forms
FMLA – General Letter – Statewide Policy
FMLA – Medical Certificate – P33a
FMLA – Notice of Eligibility, Rights & Responsibilities – HR2a
FMLA – Designation Notice – HR2b
FMLA – Intent to Return to Work – HR3
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
Employment Forms
Background Check SSA Consent Form – For Graduate Assistant & Student Employees Only
Criminal Convictions Form – Addendum to Application of Employment
Employment Application – WCSU Employment Application
Employment Eligibility Verification – Form I-9 & LINK TO: I-9 Form – List of Acceptable Documents
IPEDS – Race/Ethnicity IPED Survey Form
Health Insurance Enrollment Form
Health Enhancement Program Enrollment Form (CO-1314)
New Hire Data Sheet for Graduate Assistants
New Hire Data Sheet for Student Employees
New Hire Data Sheet for Lecturers
New Hire Data Sheet for University Assistants
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 Beneficiary – Form CO-999
Retiree Health Fund (CO-1300) Form – Fillable PDF Form
Student Employee Appointment Authorization Form
Tax Form: CT State W4-2019 – Link to: Connecticut Withholding Calculator
Tax Form: Federal W4-2019 – Link to: Federal Withholding Calculator
University Assistant Recommendation for Hiring Form – Revised 0419 – NOTE: You must have approval to hire before completing this form.
Voluntary Schedule Reduction Program – Request for Schedule Change Form – CT-HR-7c