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Notice Regarding Retirement Saving Plans for all Employees except Student Workers

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2014 Forms & Procedures

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A - B

Absence:  Leave of Absence Form (updated 8-19-14)

Absence: Faculty Report Form
Academic Freedom: Statement
Academic Productivity: Application Form (updated 4 3 13)
Accommodations Form

Address/Name Change form (updated 7-21-14)

Affidavit for Part-Time Faculty Medical
Alternate Duty Form


Assignment Preference Form 2014: Part Time Faculty [updated 12/1/14]
Benefit Universal Enrollment Form
Business Services Internal Forms & Procedures

C - D

CALSTRS Retirement Information

Classified Evaluation: Performance Evaluation Report - (SEIU) (updated 10-29-14)
Classified Evaluation: Performance Evaluation Report - (Supervisory and Confidential Employees) (updated 10-29-14)
Classified Grievance Process and Procedure Tracking Form

Classified Hourly Employee Time Sheet   [updated 7-24-14]

Classified:  Request for Reclassification Form

Classified Service Report

College Fee Reimbursement [For Classified Employees]
Colloquium: Request to Offer
Conference Leave: Expense Claim Form
Conference Leave: Request Form

Contract for Services Forms and Procedures

  - Please contact Business Services for correct and updated forms

Deferred Pay Option Form

  • Classified  [Optional for full-time Classified employees less than 12 months]
  • Faculty

Direct Deposit Form

Domestic Partnership CLPCCD Affidavit

E - F

Enrollment Form - Universal Benefits
Envoy 457 Form:  Salary Reduction Agreement Plan

Evaluation: Administrator Performance Evaluation System (PDF created 7-23-14)

Administrator Performance Evaluation Timeline/Checklist

(Please use this updated timeline/checklist for the above Administrator Performance Evaluation System)

Evaluation: Classified Performance Evaluation Report - (SEIU) (updated 10-29-14)
Evaluation: Classified Supervisory and Confidential Employees  (updated 10-29-14)
Evaluation: Counseling Faculty Evaluation Form: Student Survey (updated 10-13-14)
Evaluation: Counseling Faculty Performance Observation Form (updated 10-15-14)
Evaluation: Institutional Researcher (Special Assignment Faculty): Client Survey Form
Evaluation: Library Faculty Performance Observation Form (updated 10-14-14)
Evaluation: Library Orientation: Student Survey Form
Evaluation: Observation of Instruction Form Online Class (updated 12-18-14)
Evaluation: Observation of Instruction Form: Math X   (updated 12-18-14)
Evaluation: Observation of Instruction Form: Face to Face Class updated 10-15-14
Evaluation:  Student Response to Instruction Form:  Face to Face Class
Evaluation:  Student Response to Instruction Form:  Math X

Evaluation: Student Response to Instruction Form: Online Class

Faculty Service Area (FSA): Approval/Denial Form

Faculty Service Area (FSA): Record Form

Flex Day (Faculty)

Flexible Spending Accounts

Federal Tax Withholding Form (W-4) (2015)

G - H

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

Hiring Packets

     - Administrator Hiring Packet   [updated 5/16/15]

     - Classified, Confidential, Supervisory Hiring Packet  [updated 6/11/15]

     - Faculty Hiring Packet   [updated 6/24/15]

     - Part-time Faculty Hiring Packet   [updated 6/23/15]

     - Professional Expert Hiring Packet   [updated 5/16/15]

     - Short-Term Employee Hiring Packet  [updated 5/16/15]

     - Volunteer Hiring Packet   [updated 5/16/15]

     - Student Assistant - New Hire Packet  

     - Student Assistant - Rehire Packet (updated 7-6-15)

     - Student Assistant Salary Change Request

Reference Check Form [added 2/27/14]

Personnel Action Form (PAF) - For Hiring Manager to complete (updated 2/24/14)

Oath of Allegiance Form

Tuberculosis Certificate Information Form

Hiring Procedures (all):

                 Request to Announce - Administrator Position

                 Request to Announce - Classified Position

                   Request to Announce - Faculty Position

                   Request to Announce - Confidential/Supervisory Position

I - J

I-9 / Form and Instruction Booklet

Independent Contractors W-9 & Questionnaire Forms

    - Please follow up with Business Services on correct and updated forms.


Lab Load - Establishing Eligibility
Large Lecture: Application Form
Life Insurance Form (Basic)
Links to other Federal Internal Revenue Services
Links to other California Employment Development Departments
Load Sheet Memo and Sample


Medical Benefits:  Enrollment for Part-time Faculty
Minimum Qualifications for Faculty and Administrators in California Community Colleges, Chancellor’s Office, California Community Colleges)

Name / Address Change Form (updated 7-21-14)

Notification Procedure for Faculty Investigations


Part-Time Faculty Universal Enrollment Form

Personnel Action Form (PAF)  (revised 2/24/14)

Personnel Action Form Instructions
Pre-Retirement Load Reduction Form
Purchasing Card Activity Form


Reference Check Form [added 2/27/14]

Request to Announce Forms

  - Administrator

  - Faculty

  - Classified

  - Confidential

Request for Sick Leave Transfer (New Employees)
Retiree Medical Benefits: Letter From Charlotte Lofft dated 2/5/07
Retiree Medical Benefits: Letter From Susan Cota dated 1/19/07
Retirement Information
Retraining Leave: Contract Form
Retraining Leave: Report Form
Retraining Leave: Request Form


Sabbatical Committee Handbook [NEW! Posted 6-24-15]


Fillable pdf forms:

Salary Schedules
Salary Distribution Warrant (updated 8-18-14)
Service Report: Academic Non-Instruction (updated 10-7-14)

Service Report: Part-Time Faculty (updated 12-8-14)

Sick Leave Donation: Application (Serious Health Condition)
Sick Leave Donation: Application (Terminal Illness)
Sick Leave Donation: Donor's Leave Transfer Form
Sick Leave Transfer Form for New Employees (added 6-10-14)
Student Assistant Salary Change Form (updated 7-21-14)
Summer Assignment: Form for Load Credit 
Summer Assignment: Verification of Completion Director of Nursing
Tax Sheltered Annuity: TSA Instead of Medical Benefits Form

Tax Sheltered Annuity: Envoy Plan Services

Tax Sheltered Annunity: Envoy 403b Enrollment Form

Time Sheets & Payroll Deadline

Transfer: Notice of Involuntary Transfer   
Travel Expense Form


Universal Benefit Enrollment Form (Updated 6-5-14)
Unlawful Discrimination Complaint Form
VSP Claim Form

Variable Flex Activity

Flex Day Compensation Form

Verification of Work Experience (updated 5-16-15)

W - X

W-4 (Federal Tax Withholding Form)

Workers' Compensation

Workload Banking: Augment Sabbatical Salary
Workload Banking: Request Form


No Forms