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Forms  

The following documents require Acrobat Reader.

We are pleased to provide fillable PDF forms for your use. Please check back for updates as forms are being regularly updated. If you have any questions or suggestions please contact the Office of Human Resource Services at (925) 485-5236 or (925) 485-5238.

NEW - All hiring packets now available (see section H below).

NEW - All application employment forms

NEW - Employment Eligibility Verification Form I-9 (Narrative Instructional Power Point)

NEW - Classification Definitions of Temporary Employees

A - B

457 Employee Action Form

Envoy 403b Enrollment Form

Absence: Leave of Absence (LOA) Requests

Absence: Leave of Absence (LOA) Requests for Administrators

Guide for Administrators - how to report Leave of Absence Requests and Reporting of Absences

Absence: Report Form
Academic Freedom: Statement
Accommodations: Request Form
Address / Name Change Form (revised 9/18/07)

Applications:

Acrobat Portable Document Format (PDF) documents require Acrobat Reader.

  • Administrative/Management Employment Application
  • Faculty Employment Application
  • Classified Employment Application
Assignment Preference Form: Part Time Faculty
Auto Pay Change Form
Auto Pay Procedures
Benefit Universal Enrollment Form

C - D

Classification and Compensation Study - Job Analysis Questionnaire
Colloquium: Request to Offer
Community Partnerships: Partnership Agreement-Valley Care Nursing
Conference Leave: Expense Claim Form
Conference Leave: Request Form
Conference Leave: Out-of-State Request Form
Direct Deposit Form
Domestic Partnership CLPCCD Affidavit

E - F

Employee's Withholding Allowance (State Tax Withholding form)
Enrollment Form - Universal Benefits

Evaluation: Administrator Performance Evaluation System

Evaluation: Counselor Evaluation Form: Student Survey
Evaluation: Counselor Performance Observation Form
Evaluation: Institutional Researcher: Client Survey Form
Evaluation: Librarian Performance Observation Form
Evaluation: Library Orientation: Student Survey Form
Evaluation: Observation of Instruction Form Online Class
Evaluation: Observation of Instruction Form: Math X
Evaluation: Observation of Instruction Form: Face to Face Class
Evaluation: Student Response to Instruction Form Face to Face Class

Evaluation: Student Response to Instruction Form: Online Class

Experience: Verification for Full Time and Part Time Faculty
Flex Day: Compensation Form
Faculty Service Area (FSA): Approval/Denial Form
Faculty Service Area (FSA): Record Form
Federal Tax Withholding Form (W-4)
FSA Claim Form
FSA Dependent Care Assistance Plan
FSA Direct Deposit Form

G - H

Grievance: Tracking Form - Faculty
Grievance: Level II Form - Faculty
Grievance: Level III Form - Faculty
Grievance: Level IV Form - Faculty

Hiring Packets:

     - Adjunct Faculty Hiring Packet

     - Administrator Hiring Packet

     - Classified, Confidential, Supervisory Hiring Packet

     - Faculty Hiring Packet

     - Professional Expert Hiring Packet

     - Short-Term Employee Hiring Packet

     - Volunteer Hiring Packet

     - Student Assistant - New Hire Packet

     - Student Assistant - Rehire Packet

  

Employment Eligibility Verification Form I-9 (Narrative Instructional Power Point)

Hiring Procedures (all):


 

I - J

I-9 / Instruction Handbook - Completing the I-9

Employment Eligibility Verification Form I-9 (Narrative Instructional Power Point)

Independent Contractor Questionnaire
Independent Contractors I-9 Form

K-L

Large Lecture: Application Form
Links to other Federal Internal Revenue Services
Links to other California Employment Development Departments

M-N

Medical Benefits: Enrollment Form for Part Time Faculty
Name / Address Change Form (revised 2/22/09)

O-P

Personnel Action Form (PAF) revised 10/13/08
Personnel Action Form Instructions
Pre-Retirement Load Reduction Form
Productivity: Application Form
Professional Expert Hiring Packet

Q-R

Retiree Medical Benefits: Letter From Charlotte Lofft dated 2/5/07
Retiree Medical Benefits: Letter From Susan Cota dated 1/19/07
Retraining Leave: Contract Form
Retraining Leave: Report Form
Retraining Leave: Request Form

S-T

Sabbatical: Sabbatical Handbook
Salary Schedule: 2006-2007
Salary Schedule: 2007-2008
Salary Delivery Warrant
Service Report: Academic Non-Instruction
Service Report: Part Time Faculty
Sick Leave Donation: Application (Terminal Illness)
Sick Leave Donation: Donor's Leave Transfer Form
Sick Leave Donation: Application: (Serious Health Condition)
Sick Leave Transfer
State Withholding Tax Form (Employee's Withholding Allowance)
Student Assistant Hiring Presentation
Student Assistant - New Hire Packet (revised 12/9/08)
Student Assistant - Rehire Packet (revised 12/9/08)
Student Assistant Salary Change Request
Summer Assignment: Form for Load Credit 
Summer Assignment: Verification of Completion Director of Nursing
Tax Sheltered Annuity: Form: TSA Instead of Medical Benefits
Transfer: Notice of Involuntary Transfer   

U-V

Universal Benefit Enrollment Form
VSP Claim Form

W - X

W-4 (Federal Tax Withholding Form)
Workload Banking: Augment Sabbatical Salary
Workload Banking: Request Form

Y-Z

No Forms