Forms
This page contains Human Resources forms that are used most often. This section is meant to provide quick access to forms you already know how to use.
If you need more information or context for the forms, visit the Programs and Services section of our main page.
EDUCATIONAL ASSISTANCE PROGRAM
- Employee Tuition Waiver Application
- Dependent/Spouse Tuition Waiver Application
- EAP Related Travel (PDF,
) - Wellness Classes/Outside gym memberships (PDF, )
- Non-MC courses, seminars, conferences and workshops (PDF, )
- MC Courses, Fees and Books Form (PDF, )
- Checklist for EAP forms (PDF, )
- Part-time Faculty Professional Development Assistance Program (PDF, )
FLEXIBLE SPENDING ACCOUNTS
Pay Schedules
Individual Staff Employee Time Sheet (PDF, )
Direct Deposit Authorization Form (PDF, )
Request for Stop Payment on Payroll Check (PDF, )
Part-time Faculty Change of ESH Request (PDF, )
Earned Income Tax Credit Eligibility Noticenew window
FEDERAL AND STATE WITHHOLDING FORMS
- Employee's Federal Withholding Form (PDF, )
- Maryland Employee Maryland Withholding Form (PDF, )
- DC Employee Withholding Form (PDF, )
- Pennsylvania Employee Withholding Form (PDF, )
- Virginia Employee Withholding Form (PDF, )
- West Virginia Employee Withholding Form (PDF, )
FULL TIME FACULTY
- Instructional Evaluation Form (PDF, )
- Counseling Evaluation Form (PDF, )
- Rank Advancement Form (PDF, )
PART-TIME FACULTY
- Good Faith Consideration Appointment
- Good Faith Consideration Assignment
- Instructional Observation Form (PDF, )
- Counseling Observation Form (PDF, )
- Evaluation Form (PDF, )
- Part-Time Faculty Rank Advancement (PDF, )
STAFF
- FY20 Performance Evaluation (PDF, )
- Six-Month Probationary Staff Performance Evaluation Form (PDF, )
- Departure/Termination Check Out List (PDF, )
SHORT TERM LEAVE REQUEST FORMS
- Full Time Faculty Counseling (PDF, )
- Full Time Faculty Instructional (PDF, )
- Part-Time Faculty Counseling Leave Request (PDF, )
- Part-Time Faculty Instructional (PDF, )
- Staff Short Term Leave Request Form (PDF, )
- Short Term Disability Leave Request Form (PDF, )
FMLA
- FMLA Leave Request (PDF, )
- Certification of Health Care Provider for Employee’s Serious Health Conditions (FMLA)new window
- Certification of Health Care Provider for Family Member’s Serious Health Condition (FMLA)new window
- Certification of Qualifying Exigency for Military Family Leave (FMLA)new window
- Certification for Serious Injury or Illness of a Current Servicemember for Military Family Leave (FMLA)new window
SABBATICAL LEAVE
- Application for Sabbatical Leave (PDF, )
PROFESSIONAL DEVELOPMENT LEAVE
- Application for PDL (PDF, )
OTHER LEAVE
- Advanced Sick Leave Request (PDF, )
- Long Term Disability Claim Form (PDF, )
Flexible Work Arangements
Alternate Work Schedule:
- Application (PDF, )
Telecommute:
- Application (PDF, )
- Terms and Conditions (PDF, )
- Work Site Safety Checklist (PDF, )
Remote Work
- Application (PDF, )
- Terms and Conditions (PDF, )
- Work Site Safety Checklist (PDF, )
Compensation:
- Degree Attainment Request (PDF, )
- Position/Transfer/Unit Name Change Form (PDF, )
- Position Description (blank) (PDF, )
Workers Compensation Form (PDF, )
Request for Driving Record Consent Form (PDF, )
ADA Accommodation/Modification Request (PDF, )
Ergonomic Assessment Request Form (PDF, )
Full-time Faculty Overload Acknowledgement Form (PDF, )
Alternate ESH Assignment Request (PDF, )
Recogniton Awards
- Outstanding Service Award for Staff (one time contribution) (PDF, )
- Outstanding Service Award for Staff (exceeded expectations over the last 3 years) (PDF, )