University forms for current students, faculty and staff
University Forms
ASSESSMENT
For form, templates and guidelines, please visit the Assessment website.
FACULTY SEARCH FORMS
Fillable Certification Form Provisional Hires
Phase 3 On-Campus Interview Form
Background Clearance Release Form
Background Clearance - Fair Credit Reporting
Individualized Instruction Form (effective 10/21/15)
SCHEDULE MANAGEMENT FORMS
Change to Published Schedule (CPS) Form (effective 10/21/15)
General Education Requirements
WKE Request Form (Fall-Spring)
STUDENT FORMS
Accelerated Program Application
Add/Drop Minor or Certificate Form
Change Advisement Sheet Catalog Year
Change/Add Major or Dual Major Form
Change of Student Information Form
FERPA Consent to Release Student Information Form
Graduate Credit for Undergraduate Students
Permission to Take Courses at another College or University
Undergraduate Credit for Graduate Courses
Visiting Student Program Application (added 11/5/15)
- 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
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)
Student Loan Adjustment Forms
Miscellaneous Forms
GRE Fee Reduction Forms/Praxis Fee Waivers
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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.
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We are required to provide general financial aid information to complete the Praxis Fee Waiver.
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We must verify your Estimated Family Contribution before we can determine if you qualify for a GRE fee reduction.
Welfare Forms
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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.
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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.
ALTERNATIVE RETIREMENT PLAN FORMS
LONG-TERM DISABILITY INSURANCE FORMS
DEFERRED COMPENSATION PLAN FORMS
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
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FSA Claim Form - Information is pre-populated. Employee will nee their user id and password for ADP.
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
GROUP LIFE INSURANCE FORMS
SERS FORMS
TAX-SHELTERED ANNUITY FORMS
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
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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.
- 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®®)
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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.
- 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