HR and Benefit Forms

You must be logged into a campus computer to view these forms.  If you would like paper copies of the forms, please stop by Human Resources in Alpha Hall.

2011 Benefits Summary Brochure

Capital BlueCross website (to access provider directory, member login, etc.)

Capital BlueCross Enrollment/Change Form

CVS Caremark (prescription plan) Booklet

Delta Dental Enrollment/Change Form

Domestic Partner Benefit Policy

Employee Assistance Program

Family Recreation ID Request

Flexible Spending Account Payment Schedule

Flexible Spending Account Reimbursement Form - Dependent Care

Flexible Spending Account Reimbursement Form - Medical

FMLA Request Form

Health Reimbursement Account (HRA) Summary Plan Description

Liberty Mutual Insurance Flyer

Oil Discount Program

Reasonable Accommodation Request Form

Reasonable Accommodation Request - Physician's Certificate

Service Leave Policy

• Request to Volunteer Form
• Vacation Donation Form

 

Sick Leave Bank Provisions

• Donation Form (for faculty)
• Donation Form (for staff/administrative employees)
• Request Form

 

TIAA-CREF Defined Contribution Summary Plan Description 

Tuition Remission / Exchange Forms

• Undergraduate Tuition Remission form for EMPLOYEES and SPOUSES 
• Undergraduate Tuition Remission/Exchange form for DEPENDENTS
• Graduate Tuition Remission Eligibility form for EMPLOYEES

Verizon Wireless Employee Discount