Human Resources Forms

Benefit Forms

• YCT WHI Member Prescription Claim Reimbursement Form
• Prescription Mail in Form
• Prescription quick reference
• Medical Claim Form
• Dental Claim Form
• Flexible Spending Account Claim Form
• Tuition Waiver Forms:
  • Full Time Staff and Faculty Dependent Tuition Waiver Eligibility Form
  • Adjunct Faculty Tuition Waiver Dependent Eligibility Declaration Form
• Employee Data Form Hiring adjunct faculty? ... if so, please contact the Office of Instruction at ext. 2310

Employment Applications

• Employment applications may be found under each specific listing for Staff and Faculty Open Positions.
  
• Adjunct Faculty Employment Application

Payroll Forms

• Federal Tax form W-4
• Arizona Tax -Payroll Withholding Form A-4
• Financial System Access Form
• Child Support Wage Assignment Payroll Form
• Direct Deposit Form
• Stipend Request Form - The PAF may not be used for Stipend Requests

Other Miscellaneous Forms

• Accident / Injury Report Form
• Acceptable Use Form
• Americans With Disabilities (ADA) - Request for Reasonable Accommodation Form
• Bodily Fluids Exposure Form
• Budget Appropriation Transfer Request Form
• I-9
• ID Form (Faculty / Staff Blackboard ID Card: Data Input Form)
• ITS Software Request Form
• Leave of Absence Request Form
• Leave of Absence (FMLA) Request Form
• Notice of Separation
• Notice of Vacancy (MS Excel)
• Oath of Office Form
• Performance Appraisal
• Personnel Action Form Excel or Word format
• Selective Service Certification
• Supervisor's New Hire Checklist
• Volunteer Form