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Other Information

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

How to read you Earning Statement

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
- PDF
- MS Word
Faculty Employment Application
- PDF
- MS Word
Classified Employment Application
- PDF
- MS Word

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 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

Definition of Professional Expert

- Short-Term Employee Hiring Packet

Definition of Short-Term Employee

- Volunteer Hiring Packet

Definition of Volunteer

- 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

W - X

W-4 (Federal Tax Withholding Form)

Workload Banking: Augment Sabbatical Salary

Workload Banking: Request Form

Y-Z

No Forms