Human Resources

Forms on the Web

These links are offered to facilitate easier access to the forms that employees use most often.

Please contact Human Resources, x4302 with any questions regarding these forms.

Change of Address/Personal Information
Special Pay Policy and Form 
Independent Contractor Forms (W-9)
New York State Disability Claim Form 
Parental Leave Request Form 

 

Medical Insurance

MVP Enrollment Form
Third Party Authorization
College Student Waiver
On-Line College Student Waiver Form
Mail Service Prescription Order Form
On-Line Prescription Refill
Prescription Reimbursement Form
MVP Dental Claim Form  (for children on POS plan only)
mail dental claims to: MVP Dental Claims; PO Box 763; Schenectady, NY 12301
MVP Change of Address Form
MVP Medical Reimbursement Form
 

Dental and Vision Insurance

Dental/Vision Enrollment Form
Dental Claim Form (Certificate No. is on dental card)
Vision Claim Form (for out-of-network services only)
Authorization for Release of Protected Information
 

Domestic Partner Acknowledgement

Domestic Partner Acknowledgement
 

Flexible Spending Accounts (FSA)

Payflex Enrollment Form
PayFlex Direct Deposit Authorization Form
PayFlex Claim Form and Claim Filing Instructions
 

Life Insurance

Designation of Beneficiary Form
(For other forms, please contact Human Resources, x4689)
 

Retirement Plans

Salary Reduction Agreement (403b Contributions)
TIAA-CREF Designation of Beneficiary Form
Fidelity Designation of Beneficiary Form
 

Tuition for Dependent Children

Application for Tuition Grant for Dependent Children
 

Employee Tuition Benefits (On-campus study)

Application for Horizons Program
Application for Part-Time Study
Hamilton Honor Code
Immunization Record
Course Change Form
Tuition Waiver Request (Employee)
Tuition Waiver Request (Spouse/Partner)
 

Employee Tuition Benefits (Off-campus study)

Supervisor Approval of Program/Course
Tuition Reimbursement Request
 

Employment

General Employment Application
Summer Employment Application (available January 1-March 30)
Background Information Release (Criminal, Credit and/or DMV Record)
Recruitment Authorization Form

Payroll

Employment Authorization
Direct Deposit Form
I-9: Employment Eligibility Verification and Instructions
2012 IT-2104 (all employees must complete this form in order to work in New York State)
2012 W-4: Federal Employee's Withholding Allowance Certificate
New York State Wage Notice

Leave Bank Forms

M&O Leave Bank Donation Form
M&O Leave Bank Withdrawal Form
Staff Leave Bank Donation Form
Staff Leave Bank Withdrawal Form

 

Performance Assessment

Performance Assessment (Supervisor)
Performance Assessment (Self)

 

Worker's Compensation

Supervisor's Accident Investigation Report 
Accident Reporting Procedures
Information Release
Medical Provider Information

Cupola