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Most of these forms are now available by clicking below.
- Recruitment
- Performance Review/Evaluation
- Benefits
- FMLA
- HCRA/DepCare
- Worker's Comp/Disability Management
- General Personnel Actions
- Keys
- START
- Leave Reporting Sheet
If you wish for an emailed version of any of these forms, then please contact Laurie Pangelina, and she will send you the form via e-mail within 24 hours.
The campus Human
Resources Department has forms available on their website for a wide variety of actions. For Library Business Services forms, including travel reimbursement, please refer to the LBS webpage.
Recruitment
Academic Recruitment (the forms below are required to initiate the Academic Recruitment process)
Request to
Recruit (.doc)
Physical, Environmental and Mental Demands (The PEM) (.doc)
About
the PEM form
Staff Recruitment (all forms below are required to list a Staff job)
Job Description (.doc)
Job Summary (.doc)
Physical, Environmental and Mental Demands (The PEM) (.doc)
About
the PEM form
Request to
Recruit (.doc)
Training Plan according
to department/position needs
Current Department Organizational Chart (Org Chart examples)
PA/CRM Questionnaire for
PA or CRM positions only
Related forms for Staff Recruitment
Interview Data
Form (.doc)
Student Employee Recruitment
Student
Requisition (.doc)
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Performance Review/Evaluation
Librarian Review Cycle
Librarian Review Information
Biography
for Academic Personnel U1501 (R7/92) (.doc)
Librarian
Self-Evaluation (.doc)
Merit Increase
Review Form (.doc)
Promotion Review
Form (.doc)
Document Checklist (.doc)
Certification Statement (.doc)
Staff Performance Evaluations
Performance Appraisal 1 (.doc) - for Non-CUE employees only
Performance Appraisal 2 (.doc) - May be used for all classifications including CUE-represented employees
Overall Performance Rating (.doc)
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Benefits
UPAY 850
- Add new family members, change disability waiting period etc.
Fitsco - Sign up or change your 403(b) contributions
To change your address or tax status, use the At
Your Service website
HCRA/DepCare
HCRA Reimbursement Claim Form (.pdf)
DepCare Reimbursement Claim Form (.pdf)
SHPS - EFT Agreement Form
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FMLA - Family Medical Leave Act
Absence Request
Form
Certification
Form
Return to Work
Certification Form
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Worker's Compensation/Disability Management
Employer's Report of Incident Form (.pdf) - Worker's Compensation Pre-Claim Form
Personal Physician Pre-Designation Form (.pdf)
Volunteer
Form (.pdf)
Transitional Work Assignment Agreement (.pdf)
You can find these worker's compensation/disability management forms and more information through University Health Services.
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General Personnel Actions
Appointment Change/Personnel Action Request (The Blue) (.doc)
Supervisor's
Checklist (.doc)
Telecommunication
Agreement
Request for
Time Off (.doc)
Resignation
Form (.doc)
Student Reason
for Leaving Questionnaire
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Keys
Key Request Form (.doc)
Application
for Library Electronic Key-Card Access (.doc)
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START
START Information Page
START Contract, UCB Version (.pdf)
START Contract Amendment (.pdf)
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Leave Reporting Sheet
Monthly Leave Reporting Sheet (.xls)
Leave Reporting Sample Sheets (.pdf)
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