| Department Sponsored Volunteer Form |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
11/09 |
Volunteer Agreement and Release Form |
PDF
|
MS Word |
Do not route. Maintain copy in department file. |
| Affiliate Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
10/09 |
Letter of Affiliation (Offer letter) |
|
MS Word |
Send forms to Human Resources or COM Faculty Affairs Office. |
| X |
11/09 |
Affiliate/Associate Agreement and Release |
|
MS Word |
|
| X |
11/09 |
Person of Interest (POI) Designation Form |
PDF
|
MS Word |
For Pre-hires, Affiliates, Associates and Designated Systems Users. |
| X |
11/09 |
Affiliate/Associate Information Form |
PDF
|
MS Word |
|
| Associate Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
10/09 |
Letter of Association (Offer letter) |
|
MS Word |
Send forms to Human Resources or COM Faculty Affairs Office. |
| X |
11/09 |
Affiliate/Associate Agreement and Release |
|
MS Word |
|
| X |
11/09 |
Person of Interest (POI) Designation Form |
PDF
|
MS Word |
For Pre-hires, Affiliates, Associates and Designated Systems Users. |
| X |
11/09 |
Affiliate/Associate Information Form |
PDF
|
MS Word |
|
| Designated Systems Users |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
11/09 |
Person of Interest (POI) Designation Form |
PDF
|
MS Word |
Send forms to Systems Control. |
| X |
11/09 |
Designated Systems User Confidentiality and Agreement Form |
|
MS Word |
Will be available on Monday, November 16. |
| X |
11/09 |
Employee Information Form |
PDF
|
MS Word |
|
| Benefits Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| |
08/08 |
Qualified Domestic Partner Affidavit |
PDF |
|
|
| |
08/08 |
Child of Domestic Partner Declaration of Tax Status Form |
PDF |
|
|
| |
08/08 |
Older Child Declaration of Tax Status Form |
PDF |
|
|
| X |
11/09 |
Qualified Life Event Benefits Enrollment Form |
|
MS Word |
|
| X |
10/09 |
HSA Voluntary Contribution Designation Form |
|
MS Word |
|
| Dental Claim Forms |
back to top |
| |
|
Delta Dental Claim Form |
PDF |
|
|
| Life Insurance Forms |
back to top |
| |
7/00 |
ReliaStar Life Insurance - Enrollment Form |
PDF |
|
|
| |
8/04 |
ReliaStar Life Insurance - Request for Change Form |
PDF |
|
|
| |
10/09 |
Aetna Certificate of Coverage |
PDF |
|
|
| |
10/09 |
Aetna Summary of Coverage |
PDF |
|
|
| Short Term Disability Forms |
back to top |
| |
10/09 |
UNUM Certificate of Insurance Effective October 1, 2009 |
|
MS Word |
|
| Retirement Enrollment Forms |
back to top |
| |
3/03 |
Arizona State Retirement System Beneficiary and Enrollment Form |
PDF |
|
|
| X |
5/09 |
15 Year Service Catch-Up Contribution Form for the 403(b) |
|
MS Word |
Yes |
| Retirement Forms for Retiring Employees |
back to top |
| |
|
Retiree Health Benefits Enrollment Form |
PDF |
|
Yes |
| |
06/06 |
Retiree Accumulated Sick Leave (RASL) Form (GAO-SL-50) |
PDF |
|
Yes |
| |
06/06 |
Retiree Accumulated Sick Leave Checklist for University Employees
(Submit with RASL form) |
PDF |
|
Yes |
| |
06/06 |
Retiree Accumlated Sick Leave Federal Taxes
(Submit with RASL form) |
PDF |
|
Yes |
| |
06/06 |
Retiree Accumulated Sick Leave State Taxes
(Submit with RASL form) |
PDF |
|
Yes |
| |
06/06 |
Retiree Accumulated Sick Leave Nationwide - Deferral Notification Form
(Submit with RASL form - if applicable) |
PDF |
|
Yes |
| Flexible Spending Account Forms |
back to top |
| |
11/01 |
Flexible Spending Account Claim Form - ASI |
PDF |
|
|
| |
9/09 |
Flexible Spending Account Direct Deposit Sign Up Form |
|
MS Word |
Yes |
| Leave of Absence Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
9/09 |
Compassionate Transfer of Leave Request Form |
|
MS Word |
Yes |
| X |
9/09 |
Compassionate Transfer of Leave Contribution Form |
|
MS Word |
Yes |
| X |
9/09 |
Extended Leave of Absence Form - Classified Staff |
|
MS Word |
Yes |
| X |
8/05 |
Leave Of Absence Unpaid - Appointed Personnel: Template For Employee Request to Department Head |
|
HTML / MS Word |
|
| X |
8/05 |
Leave Of Absence Unpaid - Appointed Personnel: Template For Department Request to the Provost |
|
HTML / MS Word |
|
| X |
8/05 |
Leave Of Absence Unpaid - Appointed Personnel: Template For Department Head Approval/Denial of Employee Request |
|
HTML / MS Word |
|
| X |
9/09 |
Family and Medical Leave Request Form |
|
MS Word |
Yes |
| X |
9/04 |
FML Certification of Health Care Provider |
PDF |
MS Word |
Yes |
| X |
10/04 |
Employer Response to Employee Regarding Family and Medical Leave |
PDF |
MS Word |
|
| Compensation Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
9/00 |
Request for In-Classification Career Progression Form |
PDF |
MS Word |
Yes |
| |
7/12/01 |
Supplemental Compensation Form-Appointed Personnel |
PDF |
|
Yes |
| |
7/12/01 |
Supplemental Compensation Form-Classified Staff |
PDF |
|
Yes |
| |
7/12/01 |
Supplemental Compensation Form-Graduate Assistants/Associates |
PDF |
|
Yes |
| X |
8/98 |
Position Description Format |
Link |
|
| Pre-Employment & Background Checking Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| |
3/08 |
Candidate Consent and Disclosure Form |
PDF |
MS Word |
|
| |
8/06 |
Request for Criminal Background/DMV Check (for Positions not Maintained in Career Track) |
Online Form
(requires NetID) |
|
| |
2/05 |
Pre-Adverse Action Notice |
|
MS Word |
|
| |
2/05 |
Adverse Action Notice (Candidate) |
|
MS Word |
|
| |
2/05 |
Adverse Action Notice (Employee) |
|
MS Word |
|
| |
2/05 |
Summary of Rights under FCRA |
PDF |
MS Word |
|
| |
2/05 |
Request for Security Sensitive Status |
PDF |
MS Word |
|
| |
3/05 |
UA CDL Release Form |
|
MS Word |
|
| New Hire/Appointment Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
9/09 |
Hiring Form (Competitive and Non-Competitive) |
PDF |
MS Word |
|
| New Employee Packet Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
9/07 |
New Employee Packet |
PDF |
MS Word |
|
| |
|
The individual forms listed below are also contained in the New Employee Packet. |
|
| X |
3/07 |
New Hire Information |
PDF |
MS Word |
|
| X |
3/07 |
Employee Information Form |
PDF |
MS Word |
|
| X |
3/07 |
Notification of Policies |
PDF |
MS Word |
|
| X |
3/07 |
Benefits and Retirement Agreement |
PDF |
MS Word |
This form is no longer in use effective January 2007. The online Offer Letters include the benefits and retirement terms for all employment types. |
| X |
5/02 |
Employment Eligibility Verification (Form I-9) |
Link |
Yes |
| X |
3/07 |
State of Arizona Employee Loyalty Oath |
PDF |
MS Word |
Yes |
| X |
5/07 |
Race/Ethnicity/Sex Self-Identification Form |
PDF |
MS Word |
|
| X |
3/07 |
Veteran/Disability Self-Identification Form |
PDF |
MS Word |
|
| Classified Staff and Appointed Personnel Offer Letter Builders |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
12/06 |
Classified Staff Offer Letter Builder |
Link |
Yes |
| X |
12/06 |
Faculty and Appointed Personnel Offer Letter Builder |
Link |
Yes |
| College of Medicine Offer Letter Builders |
| X |
12/06 |
College of Medicine Clinical Faculty Offer Letter Builder (University Physicians Healthcare) |
Link |
Yes |
| Performance Evaluation Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
12/06 |
Performance Feedback for Individual Contributors [New] |
|
MS Word |
Yes |
| X |
12/06 |
Performance Feedback for Managers and Supervisors [New] |
|
MS Word |
Yes |
| X |
1/98 |
Traditional Eight-factor Report of Performance Appraisal |
|
MS Word |
Yes |
| X |
1/98 |
Objectives, Factors and Standards Format / Performance Appraisal |
|
MS Word |
Yes |
| X |
1/98 |
Factors and Standards Format / Performance Appraisal |
|
MS Word |
Yes |
| X |
1/98 |
Narrative Format / Performance Appraisal |
|
MS Word |
Yes |
| Disciplinary Action Forms - Classified Staff |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
10/05 |
Written Warning Memo Format |
HTML / MS Word |
|
Yes |
| X |
10/05 |
Disciplinary Probation Memo Format |
HTML / MS Word |
|
Yes |
| X |
1/07 |
Investigative Leave with Pay Memo Format |
HTML / MS Word |
|
Yes |
| X |
10/05 |
Pre-discharge or Pre-suspension Meeting Memo Format |
HTML / MS Word |
|
Yes |
| X |
10/05 |
Disciplinary Suspension Memo Format |
HTML / MS Word |
|
Yes |
| X |
10/05 |
Discharge Memo Format |
HTML / MS Word |
|
Yes |
| X |
05/08 |
Initial Probation Termination Memo Format (For Classified Staff on Initial Six-Month Probation Period) |
NEW TEMPLATE HERE |
|
Yes |
| X |
09/09 |
Promotion/Transfer Probationary Period Performance Improvement Memo Format (For Classified Staff on a Promotion/Transfer Probationary Period) |
NEW FORM HERE |
|
Yes |
| X |
09/09 |
Promotion/Transfer Probationary Period Termination Notice Format (For Classified Staff on a Promotion/Transfer Probationary Period) |
NEW FORM HERE |
|
Yes |
| X |
9/04 |
Job Abandonment Letter Format |
HTML / MS Word |
|
|
| Layoff (Classified Staff) and Non-renewal (Appointed Personnel) |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
09/09 |
Termination Report |
PDF |
MS Word |
|
| X |
9/04 |
Layoff Notification Memo Format for Regular Classified Staff (who have completed the initial six month probation) |
NEW TEMPLATE HERE |
|
Yes |
| X |
5/08 |
Layoff - FTE Reduction (below .50 FTE) Notification Memo Format for Regular Classified Staff (who have completed the initial six month probation) |
NEW TEMPLATE HERE |
|
Yes |
| X |
3/06 |
Nonrenewal Notification Memos (Appointed Personnel) - Contact your Organizational Consultant |
|
|
|
| Qualified Tuition Reduction Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
10/09 |
Application for Qualified Tuition Reduction |
|
MS Word |
Yes |
| X |
10/09 |
Application for Domestic Partner Tuition Program |
|
MS Word |
Yes |
| Child Care Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
|
Sick Child and Emergency/Back-Up Care Program for Students |
See LWC website |
|
| X |
|
Sick Child and Emergency/Back-Up Care Program for Employees |
See LWC website |
|
| X |
|
Employee Child Care Voucher Program Application |
See LWC website |
|
| X |
|
Employee Child Care Voucher Program Provider Verification Form |
See LWC website |
|
| Misc. Forms |
back to top |
| HR Form? |
Rev. |
Title |
Available Formats |
More info? |
| X |
11/01
3/07 |
Extended Temporary Employment Staff Memorandum of Understanding |
PDF |
MS Word |
This form is no longer in use effective January 2007. Use the online Offer Letter builder for issuing an offer letter for an Extended Temporary Employment (ETE) new hire. |
| X |
07/09 |
Request for Time In Position Waiver |
PDF |
|
Yes |
| |
4/07 |
Notice of Appointment for Graduate Assistants and Associates |
PDF |
|
|
| |
|
Request for Revision or Addition to UHAP |
|
MS Word |
Yes |