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
Part-time Lecturer 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

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
Adjunct Faculty Instructional Observation
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

Change of Name or Address
Code of Ethics Form
Direct Deposit
Dual Employment Form
Duties Questionnaire Classified Staff Only
Nursing & AH License Fee Reimbursement Form
Professional File Form
PTL Timesheet
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