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Human Resources and Affirmative Action

Forms

BENEFITS

»Benefits Forms:

Certification of Health Care Provider for Employee's Serious Health Condition (FMLA)

Certification of Health Care Provider for Family Member's Serious Health Condition (FMLA)

Health Insurance Domestic Partner Enrollment Instructions

Health Insurance Domestic Partner Enrollment Form

Leave Donation Form

MC LIfe Insurance Statement of Health

NYS Health Insurance Transaction Form

NYPERL Employee Notice and Fact Sheet (With Instructions)

NYSHIP Health Benefits Opt-Out Election Form

NYSHIP Request for Coverage Under the Young Adult Option

SUNY 403(b) Voluntary Savings Plan Salary Reduction Agreement

Retirement:

Workers' Compensation:

»Other Benefits Links and Information (Dental, Vision)

 

EMPLOYMENT

»All Employees:

Employment Application Form Adobe Acrobat PDF document

Extra Service:

I-9 / Employment Eligibility Verification Form

Name/Address Change Form

Performance Evaluation Cover Sheet - Professional Staff
Personal Information FormAdobe Acrobat PDF document

Request for Reasonable Accommodation

Request for Renewal of Appointment - Professional Staff

Staff Appointment Request Form (Appendix 18)

State Employee Statement in Lieu of Oath

Voluntary Reduction In Work Schedule (VRWS):

»Classified Employees:

Staff Appointment Request Form (Classified Service Staff Appointment Request Form)

Classified Service Staff Request and Authorization

Continued Interest Letter

CSEA Performance Program & Annual Evaluation Instructions

PEF Performance Evaluation Program

Presidential Recognition Award Program Description

Probationary Reporting Form

 

PAYROLL

>> Payroll Webpage

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