Student Services Building, Room 6381
Monday - Friday 8 a.m. to 5 p.m.
Phone (323) 343-3651 | Fax (323) 343-3662
HRM forms are listed under each unit and then alphabetically. Click on a link below to jump to the forms used by each Human Resources Management Unit.
Titles |
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Word |
Excel |
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Benefits Enrollment/Change Form |
Benefits Enrollment/Change Form-PDF | ||
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Career Development Plan Form |
Career Development Plan Form-PDF | ||
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Dependent Fee Waiver |
Dependent Fee Waiver-PDF | ||
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Employee Transaction Form |
Employee Transaction Form-PDF | ||
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Leave of Absence Request Form |
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Promissory Note |
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PS Position Number Request |
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Staff/Faculty Fee Waiver |
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Supervisor’s Orientation Checklist |
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Volunteer Form |
Benefits
Titles |
|
Word |
Excel |
|
Benefits Enrollment/Change Form |
Benefits Enrollment/Change Form-PDF | ||
|
Career Development Plan Form |
Career Development Plan Form-PDF | ||
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CFRA Medical Certification Form |
CFRA Medical Certification Form-PDF | ||
|
Dependent Fee Waiver |
Dependent Fee Waiver-PDF | ||
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Employer Paid Life and AD&D Beneficiary Designation and Change Form |
Employer Paid Life and AS&D Beneficiary Designation and Change Form-PDF | ||
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Health Care Reimbursement Account (HCRA)/Dependent Care Reimbursement Account (DCRA) Form |
HCRA/DCRA Form-PDF | ||
|
Leave of Absence Request Form |
Leave of Absence Request Form-DOC | ||
|
MEDEX® Travel Assist1 |
MEDEX Travel Assist1-PDF | ||
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Staff/Faculty Fee Waiver |
Staff/Faculty Fee Waiver-PDF | ||
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Voluntary Term Life Insurance Beneficiary Designation and Change Form |
Voluntary Term Life Insurance Beneficiary and Change Form-PDF |
Compensation and Classification
Titles |
|
Word |
Excel |
|
In-Range Progression, Bonus, Stipend Form |
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MPP Position Description |
MPP Position Description-DOC | ||
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Position Description |
Position Description-DOC | ||
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PS Position Number Request |
PS Position Number Request-PDF | ||
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Special Consultant Pay PreHire Worksheet |
Employee/Labor Relations
Titles |
|
Word |
Excel |
|
MPP Administrative Work Plan |
MPP Administrative Work Plan-DOC | ||
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MPP Evaluation Form |
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MPP Outside Employment |
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Staff Performance Evaluation for Non-Represented Employees |
Staff Performance Evaluation for Non-Represented Employees-DOC |
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Staff Performance Evaluation for Units 1, 6, 8 |
Staff Performance Evaluation for Units 1, 6, 8-DOC | ||
|
Staff Performance Evaluation for Units 2, 5, 7, 9 |
Staff Performance Evaluation for Units 2, 5, 7 ,9-DOC | ||
| Staff Performance Evaluation for Unit 4 | Staff Performance Evaluation for Unit 4-PDF |
Office of Equity, Diversity and Inclusion
Titles |
|
Word |
Excel |
|
ADA Medical Release Form |
ADA Medical Release Form-PDF | ||
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Disabled/Veteran Documentation Form |
Disabled/Veteran Documentation Form-PDF | ||
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Executive Order 1096 Form |
Executive Order 1096 Form-PDF | ||
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Executive Order 1097 Form |
Executive Order 1097 Form-PDF | ||
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Faculty Recruitment Analysis Report |
Faculty Recruitment Analysis Report-XLS | ||
|
Recruitment Analysis Report |
Recruitment Analysis Report-XLS | ||
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Student Complaint Form |
Student Complaint Form-PDF | ||
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Voluntary Self Identification Form |
Voluntary Self Identification Form-PDF | ||
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Whistleblower Complaint Procedures |
Whistleblower Complaint Procedures-PDF | ||
|
Working Conditions Demand Form |
Working Conditions Demand Form-PDF |
Faculty Affairs
Titles |
|
Word |
Excel |
|
Abort or Cancelled Faculty Search Form |
Abort or Cancelled Faculty Search Form-PDF | ||
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Employee Transaction Form |
Employee Transaction Form-PDF | ||
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Promissory Note |
Promissory Note-PDF | ||
|
PS Position Number Request |
PS Position Number Request-PDF | ||
|
Recruitment Analysis Report |
Faculty Recruitment Analysis Report-XLS | ||
|
Sabbatical Application |
Sabbatical Application-PDF | ||
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Substitute Teacher Pay Form |
Substitute Teacher Pay Form-PDF | ||
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Supervisor’s Orientation Checklist |
Supervisor's Orientation Checklist-PDF | ||
|
Working Conditions Demand Form |
Payroll
Titles |
|
Word |
Excel |
|
Absence Correction Form |
Absence Correction Form-PDF | ||
|
Change in Work Schedule Form |
Change in Work Schedule Form-PDF | ||
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Duplicate W-2 Request Form |
Duplicate W-2 Request Form-PDF | ||
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Positive Pay Time and Attendance Report |
Positive Pay Time and Attendance Report-PDF | ||
|
Special Consultant Form |
Special Consultant Form-PDF | ||
|
Special Consultant Pay PreHire Worksheet |
Special Consultant Pay PreHire Worksheet-DOC | ||
|
Student Attendance Report |
Student Attendance Report-PDF | ||
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Time and Labor Payroll Adjustment Form |
Time and Labor Payroll Adjustment Form-XLS | ||
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Verbal Employment Verification Form |
Verbal Employment Verification Form-PDF | ||
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Work Location Abbreviation List |
Work Location Abbreviation List-PDF | ||
|
Written Employment Verification Form |
Written Employment Verification Form-PDF |
Workers' Compensation
Titles |
|
Word |
Excel |
|
Employee's Report of Occupational Injury or Illness |
Employee's Report of Occupational Injury or Illness-PDF | ||
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Supervisor's Report of Occupational Injury or Illness |
Supervisor's Report of Occupational Injury or Illness-PDF | ||
|
Workers' Compensation Personal Physician Designation |
Workers' Compensation Personal Physician Designation-DOC |
Workforce Planning
Titles |
|
Word |
Excel |
|
Degree Verification Form |
Degree Verification Form-PDF | ||
|
Employee Transaction Form |
Employee Transaction Form-PDF | ||
|
MPP Position Description |
MPP Position Description-DOC | ||
|
Personnel Requisition |
Personnel Requisition-XLS | ||
|
Position Description |
Position Description-DOC | ||
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PS Position Number Request |
PS Position Number Request-PDF | ||
|
Recruitment Analysis Report |
Recruitment Analysis Report-XLS | ||
|
Salary Recommendation |
Salary Recommendation-PDF | ||
|
Supervisor’s Orientation Checklist |
Supervisor's Orientation Checklist-PDF | ||
|
Telephone Reference Check Form |
Telephone Reference Check Form-PDF | ||
|
Working Conditions Demand Form |
Working Conditions Demand Form-PDF |
