HR Forms for Staff and Faculty - Human Resources and Training

The files linked to on this page are in PDF format and Adobe Reader (free) or other software for opening PDF files is required to access them.

• General Forms
• Benefits Forms
• Adjunct Faculty Forms
• Other Forms

General HR Forms

Print, complete, and return to the Human Resources Receptionist.

• Address Change Form
• Name Change Form
• Duty Statement
• Emergency Contact Form (PDF), (DOC)
• Unlawful Discrimination Complaint Form (PDF), (DOC)

Benefits Forms

Information about Benefits.

American Fidelity Assurance, Flex Account Administration

• AFES Section 125 Flexible Benefit Plan Expense Reimbursement Voucher Form
• Dependent Day Care Reimbursement Form / Acknowledgement Form (cannot be used for medical expense reimbursement requests)

Full-time Faculty Employment Forms

Not available at this time.

Adjunct Faculty Employment Forms

Employment Forms

• New Adjunct Faculty Check List (December 7, 2010)
• Adjunct New Hire (Welcome) Memo with Links (August 1, 2010)
• Adjunct Application
• Personnel Action Form (PAF) (XLS), (PDF) (September 2, 2011)
• Minimum Qualification Equivalency Form (PDF)
• TB Test Consent Form:
  • Washington Township TB Authorization
  • Student Health Center TB Authorization
• TB Testing Information
• Emergency Contact Form (October 20, 2010)
• I-9 Form (expires August 31, 2012)
• Fingerprint Process Memorandum
• Request for Live Scan Fingerprint Form (October 14, 2010)
• Fingerprint Fees Payroll Deduction
• Loyalty Oath
• W-4 2012 Form (federal withholding)
• State Withholding (DE-4) 2012 Form
• Windfall Elimination Provision SSA-1945 Form
• Direct Deposit Authorization Form
• Other Resources
  • eCampus & LRC Faculty and Staff Training flyer
  • Adjunct Payroll Memo (January 2009)
  • Adjunct Faculty FAQs
  • 2010-2011 Faculty Handbook

Health Sciences Faculty ICL

Additional Immunization Titers, Vaccinations, Certifications and Licenses required (revised June 27, 2011).

CalPERS (California Public Employees' Retirement System)

• CalPERS website at www.calpers.ca.gov

CalSTRS (California State Teachers' Retirement System)

• Retirement Options for Adjuncts
• STRS Questionnaire
• Cash Balance Election Form
• Cash Balance Beneficiary Designation Form
• Defined Benefit Election Form
• Defined Benefit Beneficiary Designation Form
• CalSTRS or CalPERS Retirement System Election Form
• CalSTRS Acknowledgement of Receipt of Election Information Form
• Other School Districts Cash Balance Election Form
• CalSTRS Cash Balance Benefits Booklet
• CalSTRS website at www.calstrs.com

Workers Compensation

• WC Personal Physician Pre-Designation Cover Letter and Form (June 15, 2011)
• Workers Compensation Procedures (revised May 19, 2010)
• Keenan Workers Comp New Hire Pamphlet (August 2010)

Optional Contributions

• Employee Wellness & Fitness Program Guidelines
• 2011 Employee Giving Campaign (PDF)

Adjunct Benefits

• Ben Elect Accident & Sickness Insurance Plans flyer

Official Transcripts

Please contact your college and/or university for your Masters or Ph.D. official transcripts or Foreign Degree Evaluation and have them sent to the Human Resources Office at 43600 Mission Boulevard, Fremont, CA 94539.

Foreign Degree Requirements

• Foreign Degree Requirements

Classified Staff Employment Forms

Not available at this time.

Additional Types of Forms for Employees

Forms are also available on these Ohlone College websites:

• Business Services: Business and Travel Forms
• Payroll Forms
• Professional Development Forms