Human Resources Forms

PLEASE READ BEFORE USING FORMS:

Some of the forms below contain electronic signature capabilities as well as buttons that email the form directly to the appropriate department. If using Chrome, in order for these functionalities to work properly, these forms must be opened in Acrobat. You must click on the following button located on the top left of the page that opens with the form:

 

Forms work directly from page that is opened in Internet Explorer.

 General Employee Forms

• Change of Address
• Legal Name Change
• STAFF (Not Facilities) Absence/Overtime Monthly Timesheet
• FACILITIES Absence/Overtime Monthly Timesheet
• Part-Time Employees Extra Hours Timesheet
• Leave Request
• Personnel Action Form (PAF)

Union Specific Forms

CSEA

• CSEA Employee Evaluation
• Temporary Out of Classification
• Reclassification Request
• Reclassification Analysis
• Professional Growth for Coursework
• Professional Growth Verification for SCC Activities

Local 39/Operating Engineers

• Local 39/Operating Engineers Evaluation
• Reclassification

CTA

• Adjunct Office Hours
• Faculty Absence Form
• Faculty Substitute Form
• Faculty Hourly Timesheet
• Underload Agreement Form
• Bank Overload Assignment Form

Evaluation Forms

• Faculty Evaluation Form
• Faculty - Counselor Evaluation Form
• Faculty - Library Evaluation Form
• Peer Performance Evaluation
• Faculty Self Evaluation Form
• Coordinator Evaluation Form

ALG/Confidentials

Health & Welfare Forms

• Medical Benefits Form (CalPERS HBD-12)
• Delta Dental Form
• Hartford Life Insurance

Retirement/Resignation Forms

• Optional Retirement Medical Benefits – ALG
• Optional Retirement Medical Benefits – CSEA
• Optional Retirement Medical Benefits – CTA
• Optional Retirement Medical Benefits – Local 39
• Separation/Sick Leave Option Form – ALG
• Separation/Sick Leave Option Form – CSEA/Local 39
• Separation/Sick Leave Option Form - CTA

Recruitment/Hiring Committee Forms

• Requisition Form (New & Replacement Positions)
• Adjunct Requisition Form
• Interview Recommendation Form
• Reference Check
• Recommendation for Employment
• Hiring Committee Confidentiality
• Form 6

Pay & Earnings Forms

• W-4
• California DE-4 Withholding Form
• Direct Deposit Form

Envoy 403(b)

• Envoy Enrollment Instructions
• Envoy 403(b) List of Providers
• Envoy Salary Reduction Agreement (SRA) Instructions
• Envoy Salary Reduction Agreement Form

CalPERS 457 Plan

• CalPERS 457 Plan Enrollment Form
• CalERS 457 Plan Beneficiary Designation Form
• CalPERS 457 Plan Participant Change Authorization Form

Miscellaneous Forms

• Classified Employees with Adjunct Assignment Approval
• Volunteer Form