Form name and description

Form number

(Revision Date)

Accident/injury forms

Accident/injury 311 report form

Note: When you click on the link above, you will be directed to the WMU Environmental Health and Safety Web page where you will find instructions for and access to the EHS-311 form.

EHS-311

(12/01)

Physical capabilities form

Note: Print and have injured employee bring to Sindecuse Heath Center with WC-210 "Report of Claimed Occupational Injury or Illness" form (see below.)

WC-504

(07/03)

Report of claimed occupational injury or illness

Note: Print and have injured employee bring to Sindecuse Heath Center with WC-504 "Physical Capabilities" form (see above.)

WC-210

(02/09)

Business manager/hiring agent forms

I-9 form

OMB 1615-0047

(08/07/09)

I-9 form memo

HR-205

(09/09)

Position authorization form instructions:

Contact the Budget Office at 7-4275 to request the form

PSHR Electronic Workflow Web Access Authorization

Please complete this form, obtain appropriate signatures, and return to Human Resources in order to gain access to the PSHR Electronic Workflow system.

HR-201

(11/2009)

PSHR Electronic Workflow Approval Rule Change Request

Please complete this form, obtain appropriate signatures, and return to Human Resources.

HR-203

(11/2009)

PSHR KRONOS Timekeeper Report Authorization

Please complete this form, obtain appropriate signatures, and return to Human Resources in order to gain access to this report.

HR-202

(09/09)

PSHR Management Data Report Authorization

Please complete this form, obtain appropriate signatures, and return to Human Resources in order to gain access to this report.

HR-204

(10/09)

PSHR Reporting User Guides

Please visit Reporting with the PSHR System to access user guides for the electronic reporting system.

P-520

(02/04)

Staff appointment form instructions:

Contact Human Resource Services at 7-3620 to request the form.

Staff transaction form instructions:

Student employment online transactions authorization

Please complete the PSHR Electronic Workflow Web Access Authorization in order to gain access to the Student Employment Online Transaction System.

Student employment online transactions

Please use this link to access the login page for all student employment online transactions.

Designated Eligible Individual

Designated eligible individual enrollment form

HR-710

(10/08)

Employee data forms

Employee address and name change form

Note: For changes other than name, address, and phone number, please use your Employee Personal Data (EPD) form. If you do not have a copy of your EPD, contact Human Resources.

Employee home address privacy request

HR-402

(09/09)

Flexible spending accounts

BASIC Flex claim form

BASIC Flex direct deposit form

BASIC Flex enrollment booklet

BASIC Flex enrollment booklet in Spanish

Health insurance

Health insurance enrollment and change form

HR-700

(09/09)

Jury duty and court required service forms

Faculty (AAUP)

HR-334

(06/03)

HR-333

(06/03)

AFSCME employees

HR-335

(11/03)

HR-337

(06/03)

HR-336

(06/03)

Leave of absence forms

Family and medical leave - request

HR-453

(03/09)

Family and medical leave - employee information

Family and medical leave - rights and responsibilities

WHD-1420

(01/09)

Family and medical leave - medical certifications

Certification of health care provider for employee's serious health condition

WH-380-e

(01/09)

Certification of health care provider for family member's serious health condition

WH-380-f

(01/09)

Certification of qualifying exigency for military family leave

WH-384

(01/09)

Certification for serious injury or illness of covered service member for military family leave

WH-385

(01/09)

Family and medical leave - time report

HR-454

(05/04)

Non-bargaining leave of absence application

P-320

(09/06)

Consent to release leave of absence information (optional)

HR-335

(01/04)

Life insurance enrollment and change forms

Employee life insurance

HR-720

(09/09)

Dependent life insurance

For Staff Compensation System employees, Coaches, and Research (R1 and R2) employees.

HR-722

(09/09)

Long-term disability insurance forms

Long-term disability insurance enrollment and change form

HR-730

(09/09)

Long-term disability claim forms

Please click here for detailed instructions for completing and submitting these forms.

LTD Claim Application - Employee's Statement

LTD Claim Application - Other Income Questionnaire

LTD Claim Application - Attending Physician's Statement

LTD Claim Application - Tax Information

Performance management forms

SCS performance management-instructions and definitions

HR-100

(06/07)

SCS performance management-annual review

HR-101

(06/07)

SCS performance management-employee self review work sheet (optional)

HR-102

(06/07)

AFSCME probationary report-30 or 60 day evaluation

HR-314

(07/08)

AFSCME probationary report-final evaluation

HR-315

(12/07)

SCS probationary report–2 or 4 month evaluation

P-313

(06/03)

SCS probationary report–6 month evaluation

P-313

(06/03)

Retirement-related forms

Exchange authorization: 403(b) sick/annual leave exchange

Note: For use by Staff Compensation System exempt and non-exempt staff and Police Officers Association members.

(01/07)

Salary reduction agreement-calendar year 2009

Note: For 403(b) and 457(b) contributions.

Salary reduction agreement-calendar year 2010

Note: For 403(b) and 457(b) contributions.

Staff Collective Bargaining forms

Application for bargaining unit layoff

Note: For AFSCME employees under article 7.11.6

HR-500

(03/07)

Staff Compensation System forms

Appeal form

Note: For position grade appeals

P-007a

(05/09)

Job profile questionnaire (JPQ)

(02/09)

Tuition remission application

Tuition remission application

Spouse and Dependent Program

HRS-031

(01/09)