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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
Accommodations Form

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

Affidavit for Part-Time Faculty Medical
Alternate Duty Form


Assignment Preference Form: Part Time Faculty
Benefit Universal Enrollment Form
Business Services Internal Forms & Procedures

C - D

CALSTRS Retirement System Election

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

Colloquium: Request to Offer
Community Partnerships: Partnership Agreement-Valley Care Nursing
Conference Leave: Expense Claim Form
Conference Leave: Request Form

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 11-12-14)
Evaluation: Observation of Instruction Form: Math X   (updated 10-15-14)
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

Flex Day: Compensation Form
Faculty Service Area (FSA): Approval/Denial Form
Faculty Service Area (FSA): Record Form

Flexible Spending Accounts

Federal Tax Withholding Form (W-4)

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 8/18/14]

     - Classified, Confidential, Supervisory Hiring Packet  [updated 7/7/14]

     - Faculty Hiring Packet   [updated 10/16/14]

     - Part-time Faculty Hiring Packet   [updated 10/30/14]

     - Professional Expert Hiring Packet   [updated 8/19/14]

     - Short-Term Employee Hiring Packet  [updated 8/19/14]

     - Volunteer Hiring Packet   [updated 2/27/14]

[NOTE: New Minimum Wage effective 7-1-14]

     - Student Assistant - New Hire Packet   (updated 8-19-14)

     - Student Assistant - Rehire Packet (updated 8-12-14)

     - Student Assistant Salary Change Request (updated 7-21-14)

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 Contractor Questionnaire
Independent Contractors I-9 Form


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


Minimum Qualifications for Faculty and Administrators in California Community Colleges, Chancellor’s Office, California Community Colleges)

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


Part-Time Faculty Universal Enrollment Form

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

Personnel Action Form Instructions
Pre-Retirement Load Reduction Form
Productivity: Application Form (updated 4 3 13)
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


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

Service Report: Part-Time Faculty

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 ("New" 4-15-14)
VSP Claim Form

Variable Flex Activity [NEW! Posted 11-14-14]

Verification of Work Experience (updated 10-14-14)

W - X

W-4 (Federal Tax Withholding Form)

Workers' Compensation

Workload Banking: Augment Sabbatical Salary
Workload Banking: Request Form


No Forms