Professional Development Plan Form The Professional Development Plan (PDP) is a flexible document that reflects the strengths of the candidate and her/his professional development goals.
CAL-ORE Membership Application A Cal-Ore Life Flight membership ensures the patient will have no out-of-pocket flight expenses if flown by the Company or another AirMedCare Network participating provider
Career Development Plan Career Development Plans use an online submission process which provides the opportunity to sign, gain signatures and submit electronically.
Claim Form DWC1 Employee’s Report of Injury (DWC-1) – Must be given to employee at the time injury is reported to Supervisor, or as soon as possible after medical treatment is received
Savings Plus Benefits Payment Booklet This booklet contains information and a payment application to help you select the payment method that best meets your needs.
SPSL Request Form Employee will need to initiate the form and send it to supervisor for review/approval. Supervisor will need to send the completed form to mca33@humboldt.edu. Please make sure the time is also claimed in Absence Management or claimed on the employee's timesheet
Supervisor's Report of Injury Supervisor’s Report of Injury – MUST BE SUBMITTED TO HUMAN RESOURCES WITHIN 24 HOURS OF KNOWLEDGE OF INJURY
Video Display Terminal (VDT) Claim Form The VSP Video Display Terminal (VDT) Confirmation Form is only provided to CSU employees who meet the necessary job requirements as determined by the CSU campus benefits office. This form must be completed by the employee and provided to a VSP Select Network doctor to receive the supplemental VDT benefit.
VSP Premier Enrollment Form This is an Adobe Sign Form. You will need to log in with your Humboldt username account. Follow the instructions in the landing page.
Executive Order 1083: Attachment A Acknowledgement of Mandated Reporter Status and Legal Duty to Report Child Abuse and Neglect (EO 1083)
Executive Order 1083: Attachment C California law requires certain people, known as “Mandated Reporters,” to report known or suspected child abuse or neglect. You have been identified as a certain type of Mandated Reporter: a Limited Reporter under Penal Code § 11165.7(a)(41). As a Mandated Reporter, you are required by the law to sign this statement acknowledging your legal reporting obligations.
Form 801 This form is used to report certain payments received by state and local government agencies. It includes: • a payment for an official’s travel expenses for the purpose of facilitating the public’s business in lieu of a payment using agency funds; and • a payment that would otherwise be considered a gift or income to the benefiting official, but is instead accepted on behalf of the agency.
Whistleblower Complaint Form This complaint form is to be used to file a Protected Disclosure of Improper Governmental Activities and/or Significant Threats to Health or Safety under Executive Order 929.
Whistleblower Online Complaint The California Whistleblower Protection Act authorizes the California State Auditor to receive complaints from state employees and members of the public who wish to report an improper governmental activity. Note: Complaints are not accepted via email.
Onboarding
Application for a Social Security Card Apply for an original Social Security card, apply for a replacement Social Security card, change or correct information on your Social Security number record
CalPERS Member Reciprocal Self-Certification FormThe Reciprocal Self-Certification form allows you to provide essential information to your employer and will be used by your employer to enroll you into CalPERS membership.
CMS / PeopleSoft Access Form The Account Request process is used to add, modify, or delete a person's (user or developer) access to PeopleSoft Human Resources, PeopleSoft Campus Solutions, Customer Relationship Management, PeopleSoft Finance, and/or OBI enterprise applications.
EIF - Payroll Designee Use this form ONLY to change payroll designee. Employee starts the Adobe Sign Workflow.
Employee Action Request - UPDATES ONLY (EAR Form) NOTE: USE THIS FORM FOR UPDATES ONLY- This form is required from the State and is used prior to employment or to make changes during employment, for determining exemption status for taxable deductions, and any other deductions sought. This form is also used for address & withholding changes.
New Employee Sign-Up Chain of Custody Agreement We recognize that there are situations when a department will need to assist a new employee (e.g. Student Assistant or Special Consultant) with their sign-up documents. When a department commits to this responsibility, the designated person or persons commits to the proper handling of sensitive data.
Policy List Receipt Form List of some of the important policies that you should be familiar with. Signature needed indicating that you received this document.
Position Change Form Please use when funding changes are needed for current employees.
Student Payroll Action Request (SPAR) NOTE: DO NOT USE THIS FORM FOR NEW STUDENTS. Use this form for Student Assistants and Work Study Payroll updates such as address change, name change, birthdate change, withholding allowance change and ethnic correction.
Form 510 - Advice of Separation: Lecturer, FERP, Temp Librarian, TA & GA Separation form for Part-time and Full-time Lecturers, FERP participants, Teaching Associates and Graduate Assistants. Submit to Payroll and APS by effective date of separation, or deadline set by APS, whichever is earlier. This document allows Payroll to inactivate temporary academic employees whose appointments have ended and avoid overpayments.
Form 610 - Advice of Separation: Instructional Student Assistants Completed each semester in accordance with the deadlines set by Academic Personnel Services or as needed throughout the term. This document allows Payroll to inactivate temporary academic student employees whose appointments have ended.
Separating Employee Clearance Form Must be completed before final pay check is issued. This Form IS NOT for continuing FERP or Reappointed Faculty/Staff.
Temporary Telecommuting Agreement NOTE: DO NOT SEND LINK TO EMPLOYEES - Instead fill out the form with the staff member and appropriate administrator emails and names and hit the Send button.
Recruitment
*Employment Release of Information Form ***This form is only required if you don't use the "Request to Applicant for References" status in CHRS Recruiting - PageUp.*** Committees are encouraged to utilize the "Request to Applicant for References" status in CHRS Recruiting-PageUp as it will automatically prompt the candidate for additional information and alert the them that the committee intends to begin reference checks shortly. If needed, please obtain signed release of information form from candidate during their on-campus interview.
*Reference Check Information for Recommended Candidate Form The reference check forms will be submitted after moving the selected candidate(s) to the "Reference Check Successful/Recommendation to Dean for Hire" status in CHRS Recruiting (PageUp). Please be sure to document the the candidate's strengths and weaknesses in PageUp's "Search Committee Panel Review" section before you move your candidate(s) to the "Reference Check Successful/Recommendation to Dean for Hire". Please reach out to APS via email with any questions, aps@humboldt.edu.
Form 200: Position Request - Probationary Faculty Unit Employee During each academic year, a schedule is established for the submission of Probationary Faculty Unit Employee recruitment requests. Department must fill out Form 200: Position Request (Probationary Faculty Unit Employee) with required attachments for each position desired and submit it for review and approval.
Form 600: Instructional Student Assistant (ISA) Appointment Form The Submitter (generally an ASA/ASC in the department) will be entering and submitting the appointment detail into the e-Form 600. After the e-Form 600 has been submitted, an e-mail will be sent to the Submitter with a link to the form so he/she may track the status.
Form 630: Description of Duties Must be given to Academic Student Employee (ASE) at time of appointment; send electronic copy to Academic Personnel Services to be kept on file.
Form 640: Unit 11 Evaluation Criteria A written assessment for Academic Student Employee (ASE) performance. A blank copy of this evaluation form must be given to the ASE within the first fourteen (14) days of appointment if an evaluation is to take place.
Reimbursement Request Use only when a department is paying for travel expenses of interviewed candidates.
Screening Matrix: Minimum Qualification & Application Material Review Spreadsheet Complete the provided Screening Matrix by addressing the minimum qualifications listed on the posted vacany announcement. Submit form to APS when moving selected candidate(s) to the "Request to Interview - Telephone/Zoom (APS Approval Required)" status in CHRS Recruiting (PageUp). For Academic Searches Only.
Strategic Advertising/Recruitment Plan May be useful for committees to review prior to submitting their request to recruit Google Form. APS will build position in CHRS Recruiting (PageUp) and obtain quotes from advertising partners. For Academic Positions Only.
MPP Justification Form The CSU requires written justifications for both the purpose and specific number of proposed additional management positions. When filling a vacant but existing MPP position, while the form must be completed it is only necessary to indicate: the position exists, working title, the past incumbent is no longer employed with CSUB and the existing duties will continue.
Position Description Form A Position Description describes the knowledge, skills, abilities, and duties of a specific position, not the characteristics or traits of the current incumbent.
MPP Justification Form The CSU requires written justifications for both the purpose and specific number of proposed additional management positions. When filling a vacant but existing MPP position, while the form must be completed it is only necessary to indicate: the position exists, working title, the past incumbent is no longer employed with CSUB and the existing duties will continue.
Position Description Form A Position Description describes the knowledge, skills, abilities, and duties of a specific position, not the characteristics or traits of the current incumbent.
