HR HOME

BENEFITS

EMPLOYMENT OPPORTUNITIES

APPLICATIONS

FORMS/

PROCEDURES

PAYROLL SERVICES

SALARY SCHEDULES/

UNION AGREEMENTS

EMERGENCY PREPAREDNESS

********************

OTHER KEY LINKS

Mission Statement

Open Enrollment

CLPCCD Calendars

Sabbatical Committee Leave website

Board Deadlines

HR Forums

Notice Regarding Retirement Saving Plans for all Employees except Student Workers

Committee Member User Login for PEOPLEADMIN

Class-Web

FAQ's

Application for Adjunct Faculty and Short-Term Employees

View This Site in Spanish

 

 

Forms & Procedures

The following documents require Acrobat Reader.

NOTE: *Form has new Dublin Address

  

A - B

457 Employee Enrollment Booklet & Form

Envoy 403b Enrollment Form

Absence:  Leave of Absence Request (updated 5/8/13)

Absence: Faculty Report Form (updated 3/14/13)
Academic Freedom: Statement
*Accommodations: Request Form

*Address / Name Change Form (Updated 4 17 13)

Applications

Assignment Preference Form: Part Time Faculty
Auto Pay Change Form
Auto Pay Procedures
Benefit Universal Enrollment Form

C - D

CALSTRS Retirement System Election

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

*Classified Service Report

CLPCCD Retirement Savings Plans
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 (updated 3-21-13)

E - F

Earnings Statement:  How to Read

Employee's Withholding Allowance (State Tax Withholding form)

Enrollment Form - Universal Benefits
Envoy 457 Form:  Salary Reduction Agreement Plan [for PERS members]

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

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

     - Part-time 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

     - Student Assistant Salary Change Request

Personnel Action Form (PAF) - For Hiring Manager to complete

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 - Classified Position

I - J

I-9 / Form and Instruction Booklet (**NEW**)

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, Chancellor’s Office, California Community Colleges)

*Name / Address Change Form (Updated 4 17 13)

O-P

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 (updated 4 3 13)
Purchasing Card Activity Form (updated 11/8/12)

Q-R

Request to Announce Forms

*Request for Sick Leave Transfer
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

S-T

Salary Schedule: 2006-2007
Salary Schedule: 2007-2008
*Salary Delivery Warrant
*Service Report: Academic Non-Instruction

Service Report: Part Time (Adjunct) Faculty

*Sick Leave Donation: Application (Terminal Illness)
*Sick Leave Donation: Donor's Leave Transfer Form
*Sick Leave Donation: Application: (Serious Health Condition)
State Withholding Tax Form (Employee's Withholding Allowance)
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

Time Sheets

*Transfer: Notice of Involuntary Transfer   

Transit and Parking Plan: Enrollment Form

Transit and Parking Plan: Frequently Asked Questions

Travel Expense Form (re DO Admin Services Website)

U-V

Universal Benefit Enrollment Form
VSP Claim Form
Verification of Work Experience **New**

W - X

W-4 (Federal Tax Withholding Form)

Workers' Compensation

Workload Banking: Augment Sabbatical Salary**New**
Workload Banking: Request Form**New**

Y-Z

No Forms

NOTE: *Form has new Dublin Address