Absence Reports/Timesheets
- Absence Report for Classified Employees BS-59
- Absence Report for Certificated Employees BS-137
- Classified Employees Differential and Overtime Timesheet BS-139
- Student Help Timesheet BS-91
- Temporary Classified Timesheet BS-68
Adjunct Insurance Forms
Domestic Partner Forms
Leave Forms
Catastrophic Leave
Classified Staff
- Application for Catastrophic Leave for Classified and Management Employees BS-185
- Catastrophic Leave Medical Certification BS-184
Certificated Staff
- Extended Catastrophic Leave Application for Faculty
- Extended Catastrophic Leave Physician Statement for Faculty
- Authorization for Release of Faculty Medical Information
- Immediate Family Catastrophic Leave Application for Faculty
- Immediate Family Catastrophic Leave Physician Statement for Faculty
Five Month Law
- Five Month Law Physician's Verification
- Verification of Illness Form – Not for use for Five Month Law or Catastrophic Leave
Family Medical Leave Act (FMLA)
- FMLA Request BS-186
- Certification of Health Care Provider for Employee's Serious Health Condition WH-380-E
- Certification of Health Care Provider for Family Member's Serious Health Condition WH-380-F
Parental Leave
Certificated Only
- Parental Leave of Absence for Birthing Parent (LRCFT)
- Parental Leave of Absence for Non-Birthing Parent (LRCFT)
General
Sick Leave and Vacation Forms
Unpaid Leave
Long-Term Care Insurance Forms
Class 001 – Classified Staff Working at Least 20 Hours Per Week
Class 002 – Certificated Staff Working at Least 50%
Class 003 – Adjunct/Permanent Part-Time Staff (Not Qualified for Class 001 or 002)
New Hire Forms
Retirement Savings Plan Forms
403B Savings Plan
457 Savings Plans
Retirement Savings Distributions
Questions?
Contact Employee Benefits for more information.