Human Resources Forms

Employment Forms

Board of Regents Application (PDF)
Employment Eligibility Verification: Form I-9
Classified Positions Only: CT-HR-12

Employment Request Forms

Clinical Faculty Request
Educational Assistant Request
Non-Credit Lecturer Request
Notetaker Request
Student Laborer/Work Study Request
Work Schedule Form

AFT Forms

AFT Faculty Promotion Application
AFT Counselors & Librarians Promotion Application
AFT Tenure Application
AFT Sabbatical Application
AFT Counselors & Librarians Evaluation Form
AFT Travel Stipend Form
AFT Appendix A and Schedule C Document

Congress/AFSCME Forms

4C's Promotion Application
AFSCME Promotion Application
4C's Faculty Promotion Application
AFSCME Admin Promotion Application
Congress & AFSCME Minimum Qualifications
Congress Faculty Minimum Qualifications


4C’s Tenure Application
AFSCME Tenure Application

4C's Sabbatical Application
AFSCME Sabbatical Application

4C's & AFSCME Evaluation Form
4C's Classroom Evaluation Form
4C's + AFT Faculty Evaluation Form
Department Chair Evaluation Form  

Classified Evaluation Forms

A&R Staff
Clerical Staff
Maintenance Staff
Protective Services Staff

Leave Related Forms

Medical Certificate - P33a
Caregiver Medical Certificate - P33b
FMLA - Employee Request - HR1
FMLA - Intent to Return to Work - HR3
Personal Leave
Sick Leave Bank Application

Miscellaneous Forms

Adjunct Faculty Instructional Observation
Change of Name or Address
Code of Ethics Form
Direct Deposit
Dual Employment Form
Duties Questionnaire Classified Staff Only
Faculty Consulting and Research Procedures
Nursing & AH License Fee Reimbursement Form
Professional File Form
SERS Post Retirement Form
Sexual Harassment Form
Tuition Reimbursement Form Classified Staff Only
Voluntary Schedule Reduction Program Form

Retirement Election/
Beneficiary Form


Tax Forms

State Withholding: CT State W4-2016
Federal Withholding: Federal W4-2016

Worker's Compensation

Accident Report Form
Verification of Medical Appointment Form
Medical Directory