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Human Resource Services

• Message from Chancellor Joel L. Kinnamon
• Message from Vice Chancellor Mary Anne Gularte
• Meet the Human Resource Services Staff
• Forms and Procedures
• Collective Bargaining Agreements and Salary Schedules
• HR Forums
• Board Deadline Dates for HR (2011)
• CLPCCD Calendars
• Classified Classification and Compensation Study
• Chabot-Las Positas Community College District Reorganization -Position Statement
• The Registry (adjunct positions)
• Faculty Sabbatical Information

Emergency Preparedness

& Workplace Safety

• Emergency Information
• H1N1 Info
• EPWS Committee Meeting Dates
  • Nov Draft Meeting Minutes

Benefits

• Open Enrollment
• Benefits Services
• Benefit and Payroll Information Summary
• Premium Rates
• Benefit Bridge
• Retirement Benefits

Payroll

• Payroll Services

Other Information

• Contact Us
• Class-Web
• Chabot Credit Union
• Driving Directions
• FAQ's
• Application for adjunct faculty and short-term employees

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 updated regularly. 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 - 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 (updated 12/21/11)

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

Classified Evaluation: Performance Evaluation Report - (SEIU)

Classified Evaluation: Performance Evaluation Report - (Supervisory and Confidential Employees)

Classified Hourly Employee Time Sheet (updated 11/15/11)

Classified Service Report

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

Earnings Statement:  How to Read

Employee's Withholding Allowance (State Tax Withholding form)

Enrollment Form - Universal Benefits

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

Evaluation: Performance Evaluation Report - Classified (SEIU)

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 CLPCCD Checklist Form (for all hires) Professional Expert Flow Chart Use of Professional Expert Employee Definition of Professional Expert      - Short-Term Employee Hiring Packet CLPCCD Checklist Form (for all hires) Short-Tern Flow Chart Use of Short-term and Substitute Employees Definition of Short-Term Employee      - Volunteer Hiring Packet CLPCCD Checklist Form (for all hires) Definition of Volunteer      - Student Assistant - New Hire Packet      - Student Assistant - Rehire Packet    Personnel Action Form (PAF) - For Hiring Manager to complete I-9 Form  * Employment Eligibility Verification Form I-9 (Narrative Instructional  Power Point) Oath of Allegiance Form Tuberculosis Certificate Information Form

Hiring Procedures (all): Administrative/Management Hiring Procedures (11/2005, revised 5/9/06) Classified Hiring Procedures (11/2005, revised 11/2011)NEW Faculty Hiring Procedures (Revised 6/23/2009 Supervisory/Confidential Hiring Procedures (11/2005, revised 6/7/2008)

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

Life Insurance Form (Basic)

Links to other Federal Internal Revenue Services

Links to other California Employment Development Departments

M-N

Medical Benefits: Enrollment Form for Part Time Faculty

Minimum Qualifications for Faculty and Administrators in California Community Colleges (March 2010, Chancellor’s Office, California Community Colleges)

Name / Address Change Form (updated 12/21/11)

O-P

Personnel Action Form

Pay: How to Read Your Earnings Statement

Performance Evaluation Report - Classified (SEIU)

Personnel Action Form (PAF) revised 10/13/08

Personnel Action Form Instructions

Pre-Retirement Load Reduction Form

Productivity: Application Form

Purchasing Card Log Form (revised 08/09)

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 Salary Change Request

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

Transfer: Notice of Involuntary Transfer

Transit and Parking Plan: Enrollment Form Transit and Parking Plan: Frequently Asked Questions

U-V

Universal Benefit Enrollment Form

VSP Claim Form

W - X

W-4 (Federal Tax Withholding Form)

Workers' Compensation Workers' Compensation Instructions for Supervisors Workers' Compensation Claim Form (DWC 1) Supervisor's Report of Employee Injury Designated Medical Providers for Workers' Compensation

Workload Banking: Augment Sabbatical Salary

Workload Banking: Request Form

Y-Z

No Forms