Forms

Pre-Employment

• Employee Referral Form
  Enter a drawing to be rewarded for inviting talented people to work at L&C.
• Faculty Background Check Authorization
  Final Candidates Only
• Staff Background Check Authorization
  Final Candidates Only
• Summary of Fair Credit Reporting Act
  Understand your rights
• List of Appropriate Documents for the I-9
  What to bring on your first day.
• Staff Handbook
  To acquaint you with the College’s policies, procedures, and practices.
  Not every policy or practice of the College is contained in this Handbook.

Contact Info

• Would you like to update your address?
  Please complete our online form.
• Personal Information Sheet
  For new employees who wish to provide their contact information
  

Payroll

• W-2 2009 Duplicate Request  
  Submit this form to receive a duplicate W-2 for 2009 (Duplicates will be sent at the end of Feburary, 2010)
• Direct Deposit Enrollment
  Sign up for direct deposit and electronic statements.

• Electronic Statement Enrollment
  Sign up for electronic pay advices.
• Form W-4
  Designate your tax withholdings.
• Pay Statement Replacement Form
  To request a duplicate pay statement or advice.
• Time Sheet (Non-Exempt 2009-2010)
  Record your regular hours, vacation, and sick pay.
• Time Sheet Instructions (Non-Exempt)
  Some steps to complete your time sheet properly.
• Employee Absence Report (Exempt)
  Record your vacation and sick days.

Accommodations

• Reasonable Accommodation Request
  Assist the College in making reasonable accommodations.
• Disability Verification
  Determine your eligibility for accommodations.

Benefits

• Benefits Enrollment/Changes
  Medical, Dental, Life, AD&D, and Flexible Spending. Submit within 31 days of Hire or Qualifying Event date.
• Flexible Benefits & Debit Card Enrollment Form
  Submit this form within 31 days of hire to enroll in a flexible spending account.
• Adding a Spouse or Domestic Partner
  Submit within Open Enrollment, or within 31 days of Hire or Qualifying Event date.
• Remove Domestic Partner
  Submit within 31 days of Qualifying Event.
• 2010 TIAA-CREF Retirement Plan Enrollment/Changes
  You can turn in this form at any point to make changes to your retirement contributions.
• Voluntary Life Insurance Enrollment Form
   You can turn in this form at any point .
• Personal Choice: Healthcare Flexible Spending Account Claim Form
  Submit your claim form with your receipts for reimbursement. Deadline June 30, 2010.
• Personal Choice: Dependent Care Flexible Spending Account Claim Form
  Submit your claim form with your receipts for reimbursement. Deadline June 30, 2010.
• Sick Leave Sharing Program Pledge Card
  Volunteer to help your non-exempt colleagues.

• Sick Leave Sharing Program Request Form
  You may apply to receive additional sick leave pay after exhausting your own accrued sick leave and vacation hours due to your own serious illness.

Leave of Absence

• Leave of Absence request for Family or Medical Leave
  To take your FMLA/OFLA protected leave, please submit your request.
•  Certification from Health Care Provider for Employee's Serious Health Condition
   Have your healthcare provider complete if you are taking time off for your own medical condition.
• Certification from Health Care Provider for Family Member's Serious Health Condition
  Give this form to your family member's healthcare provider to document the need to provide care.
• Certification from Health Care Provider for Serious Injury or Illness of Covered Servicemember
  Give this form to your covered servicemember's health care provider to document the need to provide care.
  
• PHI Release of Own Health Info Form
  You must authorize the disclosure of your protected health information if you are taking time off for your own condition.
• PHI Release of Dependent's Health Info Form
  Your dependent must authorize the disclosure of their protected health information if you are taking time off to care for your family member. 
• Fitness for Duty Form
  If applicable, have your healthcare provider complete this form at the end of your own serious health condition leave to ensure you are physically ready to return to work.

Position Changes and Additions

• Position Description Questionnaire (PDQ)
  Required to make changes to current job or to create a new position.

Performance Evaluations

• Exempt Staff Evaluation
  Due June 30th of every year. 
• Support Staff Evaluation
  Resources, tips, and forms for a successful and helpful evaluation. 
• Performance Evaluation Tip Sheet

Exit Survey

• Click Here to take Exit survey
  (password required, please e-mail hr@lclark.edu for details)