These forms are presented as Microsoft WordTM templates so they can be completed electronically. To complete the form, download the template and type the information requested in the appropriate fields. Then use “Save As” under Word’s file menu to save the completed form as a Word document file.
Forms
- Accident Investigation and Prevention Report
- Certification of Health Care Provider for Employee’s Serious Health Condition – FMLA(622 KB PDF)
- Certification of Health Care Provider for Family Member’s Serious Health Condition – FMLA(522 KB PDF)
- Conflict of Interest and Ethics(386 KB PDF template)
- COVID Supplemental Paid Sick Leave
- Discrimination, Harassment & Retaliation Complaint Form
- Domestic Partners Affidavit for Group Insurance(27 KB Word template)
- Domestic Partners Affidavit for Tuition Remission(56 KB Word template)
- Educational Assistance Application(37 KB PDF template)
- Educational Assistance Application CGU(81 KB PDF template)
- Employee Corrective Action (270 KB Word docx)
- Employee Information Release Form(158 KB PDF)
- Employment Discharge Form
- Faculty Contract for Tenured Faculty(80 KB Word docx)
- Faculty Contract for Tenure-Track or Non-Tenured Faculty(72 KB Word docx)
- Faculty Contract Salary & Workload Agreement for Tenured Faculty(73 KB Word docx)
- Faculty New Hire Checklist Form for New Faculty Packets(49 KB Word docx)
- Health Club Membership Reimbursement Form
- HCP Credentialing Checklist Dental 5-03-2021
- HCP Credentialing Checklist DO-MD-DPM-PT-NP-PA 5-01-2021
- HCP Credentialing Checklist Optometry rev 05-01-2021
- Hiring Supervisor’s Orientation Checklist(67 KB Word template)
- Interviewer’s Guide and Report(68 KB Word template)
- Kudos and Suggestions(web form)
- Mandated Reporter Form
- Mentor Guide to the Title IX Process(120KB PDF)
- Mentor Request Title IX Process(112KB PDF)
- Multi-Year Non-Tenure Track Faculty Contract(62 KB Word docx)
- New Employee Safety Training Record(32 KB Word template)
- New Hire Checklist(html form)
- Non-Tenure Track Multi-Year Workload Agreement(77 KB Word docx)
- Notice of Adjunct Faculty Limited Appt(22 KB Word docx)
- Notice of Faculty Appointment and Agreement of Employment(25 KB Word docx)
- Offer Letter – Administrative Position(28KB Word docx)
- Offer Letter – Auxiliary Faculty Appointments(27KB Word docx)
- Offer Letter – Regular Faculty Appointments(28KB Word docx)
- Offer Letter – Post Doctoral Fellow(27KB Word docx)
- Offer Letter – Staff Position(30KB Word docx)
- Offer Letter – Temporary Position(28KB Word docx)
- PeopleAdmin User Authorization(192 KB PDF file)
- Performance Appraisal – Sharepoint Annual Evaluation
- Performance Appraisal (Special) for Employee Development-Exempt(68 KB Excel file)
- Performance Appraisal (Special) for Employee Development-Non-Exempt(68 KB Excel file)
- Performance Appraisal – PeopleAdmin Annual Evaluation – Employee’s Quick Guide(605 KB PDF)
- Performance Appraisal – PeopleAdmin Annual Evaluation – Supervisor’s Quick Guide(754 KB PDF)
- Performance Evaluation_Performance Factor Comments
- Performance Evaluation-Quarterly Self Evaluation for Exempt Employee
- Performance Evaluation-Quarterly Self Evaluation for Non-Exempt Employee
- Performance Improvement Plan
- Personnel File Inspection Request form
- Position Description Questionnaire(139 KB Word template)
- Position Request Form Template
- Practicing Physician Agreement(28 KB Word docx)
- Rationale Statement(49 KB Word template)
- Reports Request Form
- Retirement Salary Deduction/Reduction Agreement
- Rideshare Online Incentive Form
- Statement of Termination of Domestic Partnership
- Telecommuting Agreement
- Tuition Remission Application(120 KB pdf file)
- Tuition Remission Grandfather Benefit Chart(148 KB PDF file)
- University of LaVerne Partnership in Education Form(517 KB PDF file)
- Volunteer Registration Form(28K B PDF file)
- Weight Watcher’s Reimbursement Form (30 KB Word template)
- WesternU 403(B) Summary Plan Description (Login Required)
- WHCRA Notice
- Workers Compensation Forms – California(5MB PDF file)