University forms for current students, faculty and staff

 

ASSESSMENT

For form, templates and guidelines, please visit the Assessment website.

FACULTY SEARCH FORMS

Act 48/45 Request Form

Ad Copy Form

Background Check Form

Job Description Form

Fillable Certification Form Provisional Hires

Phase 1 Initial Review Form

Phase 2 Phone Interview Form

Phase 3 On-Campus Interview Form

Background Clearance Release Form

Background Clearance - Fair Credit Reporting

Good News Submission Form

Individualized Instruction Form (effective 10/21/15)

Reportable Offense Form

SCHEDULE MANAGEMENT FORMS

Change to Published Schedule (CPS) Form (effective 10/21/15)

Faculty Hiring Form

General Education Requirements

WKE Request Form (Fall-Spring)

STUDENT FORMS 

Accelerated Program Application

Add/Drop Form

Add/Drop Minor or Certificate Form

Audit a Course

Change Advisement Sheet Catalog Year

Change/Add Major or Dual Major Form

Change of Student Information Form

Challenge Course Form

Course Substitution

Credit Overload Form

Duplicate Diploma Order Form

FERPA Consent to Release Student Information Form

Graduate Credit for Undergraduate Students

Permission to Take Courses at another College or University

Request for Notary Services

Undergraduate Credit for Graduate Courses

Visiting Student Program Application (added 11/5/15)

 

• Missing Receipt Form
• Justification of the Purchase of Food
• Justification Acknowledgement
• Travel Approval and Expense Report
• Travel - Per Diem Rates | GSA

 

• Admission to Teacher Education
• Certification Instructions-Teacher
• Certification Testing Requirements
• Clearance information for Teacher Education Students
• Code of Conduct
• Conceptual Framework
• Corrective Action Plan
• Course Substitution
• Credit Overload Form
• Field Experience Handbook
• PDE-430 - Evaluation Form for Student Professional Knowledge and Practice
• PennWest Application for Student Teaching
• Request to Take Course with Student Teaching
• Student Teacher Manual
• TIMS Credential Application

 

• 60+ Cap Application

• Entrance Digital Sign Form

• Administrative Diversity Recruitment Plan for Faculty Job Postings
• Preferred First Name Request Form

 

• Facilities Work Request System
• Space Utilization Form

 

• Promotion Application
• Promotion Application (Appendix B1)
• Promotion Application (Appendix B2)
• Sabbatical Leave Application

 

• FFERPA Consent to Release Student Information Form

 

2019-2020 Verification Worksheets

2019-2020 Dependent Verification

2019-2020 Independent Verification

2019-2020 Household and College Size Worksheet

2018-2019 Verification Worksheets

2018-2019 Dependent Verification

2018-2019 Independent Verification

2018-2019 Child Support Paid Worksheet

2018-2019 Child Support Received Worksheet

2018-2019 Food Stamp/SNAP Worksheet

2018-2019 Household and College Size Worksheet

2018-2019 Untaxed Income Worksheet

Graduate Assistantship Timesheets

GA Timesheet 300 Hour
GA Timesheet 200 Hour
GA Timesheet 100 Hour 

Identity and Statement of Educational Purpose Form

2020-2021 Identity and Statement of Educational Purpose Form

PHEAA State Grant

PHEAA State Grant General Forms 

Satisfactory Academic Progress (SAP)

SAP Appeal Form

SAP Maximum Time Frame Appeal

Student Loan Adjustment Forms

Student Loan Adjustment Form

Miscellaneous Forms

GRE Fee Reduction Forms/Praxis Fee Waivers

• Please be advised that forms submitted to the Financial Aid Office for completion will be processed within 1-2 business days. The forms may then be picked up at our office and the student is responsible for submitting the form for testing.

• We are required to provide general financial aid information to complete the Praxis Fee Waiver.

• We must verify your Estimated Family Contribution before we can determine if you qualify for a GRE fee reduction.

Welfare Forms

• Please be advised that welfare forms submitted to the Financial Aid Office for completion will be processed within 2-3 business days. The forms will be faxed to the appropriate agency, and the student may also receive a copy for their records.

• We are required to provide your cost of attendance and financial aid information (loans not included) in order for you to complete the forms. Please note: Forms submitted to our office without the student's signature of release will not be processed.

Scholarship/Miscellaneous Forms Requiring Financial Aid Information

• Please be advised that forms submitted to the Financial Aid Office for completion will be processed within 3-5 business days.

• Accelerated Program Application

• Audit a Course
• Course Substitution Form

• Graduate Credit for Undergraduate Students
• Requirements and Guidelines for the Preparation of the Master's Thesis/ Doctoral Dissertation
• Second Master's Degree Approval Form
• Transfer Credit Form
• Undergraduate Credit for Graduate Courses

 

• Housing Resident Handbook
• Room Consolidation Process

 

• Worker's Compensation Claimant Information

ALTERNATIVE RETIREMENT PLAN FORMS

• Alternative Retirement Plan Change Form

LONG-TERM DISABILITY INSURANCE FORMS

• CIGNA Long-Term Disability Evidence of Insurability

DEFERRED COMPENSATION PLAN FORMS

• Deferred Compensation Plan Beneficiary Designation Form
• Deferred Compensation Plan Enrollment Form

FAMILY AND MEDICAL LEAVE ACT FORMS

• HIPAA Form 11-3-2015
• AFSCME-SPFPA (SPF) Employee Serious Health ConditionCertification Form
• AFSCME-SPFPA  (SPF) Family Member Serious Health Condition Certification Form  
• FMLA Employee Serious Health Condition Certification Form
• FMLA Family Member Serious Health Condition Certification Form
• AFSCME-SPFPA  (SPF) Absence Request Form
• Faculty-Coaches Absence Request Form
• Manager Absence Request Form
• OPEIU Absence Request Form
• SCUPA Absence Request Form

FLEXIBLE SPENDING ACCOUNT FORMS

• FSA Claim Form - Information is pre-populated. Employee will nee their user id and password for ADP.

• FSA Enrollment Change Form

HEALTH INSURANCE FORMS FOR FACULTY, MANAGERS, NURSES, COACHES AND POLICE OFFICERS

• PASSHE Enrollment/Change Form for Managers, Faculty, Nurses, Police and Coaches
• PASSHE Spouse/Dom Partner Health Care Enrollment Attestation - on/after July 1, 2013
• PASSHE Spouse/Dom Partner Health Care Enrollment Attestation - before July 1, 2013

HEALTH INSURANCE FORMS FOR AFSCME AND SCUPA

• PEBTF Enrollment Change Form
• PEBTF Attestation Form
  • PEBTF Employer Benefit Verification Form

GROUP LIFE INSURANCE FORMS

• MetLife Insurance Beneficiary Form

SERS FORMS

• SERS Beneficiary Form

TAX-SHELTERED ANNUITY FORMS

• Tax-Sheltered Annuity (403b) Salary Reduction Agreement

TUITION WAIVER FORMS

• Tuition Waiver Form (universal form - used for all semesters -

  PennWest California

  classes only)
• Class Schedule Form (for employees only)
• Graduate Level Taxation Form and Instructions (for employees taking graduate classes only)
• Tuition Waiver Late Fee Form

FACULTY HEALTH AND WELFARE FUND

• Faculty Dental and Vision information may be found at PAFAC website.

VOLUNTARY GROUP LIFE/AD&D FORMS

• Voluntary Group Life Insurance Enrollment/Medical History Form
• Voluntary Group Life Insurance Conversion Application
• Voluntary Group AD&D Insurance Conversion Application
• Voluntary Group Life Insurance Portability Application

EMPOWER RETIREMENT (FORMALLY KNOWN AS GREAT WEST)

• Visit Empowerment Retirement's website to access current forms.

 

• Addendum Form
• Addendum Form - Fillable

 

• IRB Review Request
• Review Request Checklists
• IRB Photo Release Form
• Informed Consent Checklist
• Survey-Questionnaire-Interview Consent Checklist
• IRB Faculty Authorization Application

 

• Medical Information Form
• Meningitis Waiver Form

• Requirements for Verification of Military Status
• Fall 2017 - Application for Enrollment (Chapters: 30, 31, 35, 1606-1607) 
• Fall 2017 - Application for Enrollment (33 - Post9/11 GI Bill®^®)

• Driver History Form
• Event Parking Request

 

• Change of Address
• Direct Depost
• Employee Compensation
• ESS Tutorial
• Ess Tutorial - Students
• Form I-9 Instructions
• Individual Expense
• Pay Option
• Permanent Faculty New Hire
• Staff New Hire
• Student Mandatory Instructions to Read
• Student New Hire Forms
• Temporary Faculty New Hire

 

• Right to Know Request

• Faculty Disclosure of Time - Attachment A

• Time and Effort Report - This is a fillable form.  Print after entering information.
• Dual Employment Form - This form is not a fillable form.  Please print and fill in manually
• Grant Funded Contract Request Form - This form in not a fillable form.  Please print and fill in manually.
• Student Payroll Form for Grant Funded Projects - This form is not a fillable form.  Please print and fill in manually.
• GA - Grant Hiring Form - This form is fillable.  Please print and have student sign the form.

 

• Accomodation Agreement
• OSD Application

 

• Call for Proposals
• Application Form
• Cover Sheet
• Budget Form
• Proposal Scoring Rubric
• Student Travel Fund Policy
• Individual Student Travel Fund Application
• Student Group Travel Fund Application
• Student Group Member Travel Information Form
• Faculty Mentor Travel Fund Application
• Project Summary Form
• Student Travel Fund Reimbursement Form

• Request an edit or change to the website