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Human Resources Forms

Accident, Injury, Accommodation Forms

Employees (including student state workers injured on the job)

Students & Members of the Public

Voluntary Self-Identification of Disability


Appointment/Search Process Forms

New Adjunct Information Form

Interview Exchange Information Request

Business Card Request

New Instructor Information

Child Protection

SUNY Child Protection Policy

SUNY's Mandatory Reporting Policy

SUNY Delhi Procedure

SUNY's Decision Tree

Key Contact Information

Child Protection Policy Acknowledgment Form

Approval form for events involving children under age 17

Child Protection Policies training now available in Vancko Hall!
Moodle Powered LogoClick here to launch the training
             1. sign into Vancko Hall
             2. in the upper right corner, type into the search bar Child Protection, search  
             3. click on the course SUNY Delhi Child Protection Policies Training
             4. click Enroll Me
             5. begin the course by clicking Start Here 
Have a large group that needs training?
Contact Glenda Roberts at 607-746-4548 or via email at


Evaluation, Performance Program and Annual Report Forms

Classified Service Supervisor's Probationary Report

CSEA Performance Program and Evaluation

Faculty Annual Report and Performance Program 

Professional Employees' Evaluation Report

Professional Employees' Performance Program

Security Employees' Performance Program and Evaluation

Security Supervisors' Performance Program and Evaluation


Dental and Vision Forms

Dental Claim (CSEA)

GHI Dental Claim (M/C)

Delta Dental Claim  (UUP)

Davis Vision Direct Reimbursement Claim (UUP & M/C)

Benefit Trust Student Verification (UUP)

Student Verification (M/C)


Dependent Care

Dependent Care Advantage Account Reimbursement

Health Insurance Forms

Empire Plan Claim

All Flex Spending Reimbursement forms

Health Insurance Enrollment

Domestic Partner


Address Change & Emergency Contact Information

Update your address and other personal information with HR

Add or remove emergency contacts

ERS - Employee Retirement System Address Change

TRS - Teachers' Retirement Address Change

TIAA-CREF address change (you will be prompted to log in)

PFRS - Police & Fire Retirement System Address Change

UUP Address Change

CSEA Address Change

PBA Address Change (you will be prompted to log in)


Leave Forms

Request For Leave Form 

Leave Donation Form 

Unclassified Staff Leave Report

Family Medical Leave Act Forms

FMLA Rights and Responsibilities Notice

FMLA Notification Form

FMLA Approval/Disapproval

Employee’s Serious Illness 

Family Member’s Serious Illness 

Military Family Leave 

Military Family Member’s Injury 


Retirement Forms

New York State Employees' Retirement System (ERS)

New York State Teachers' Retirement System (TRS)


Salary Reduction Agreement


Student Employment Forms

College Work Study Request

Student Assistant Request

Student Employment Application

Work Study Evaluation Sheet 

Student Assistant Evaluation Sheet 

Request for Student Employment - Summer

Confidentiality Compliance Agreement for Student Employees

Tax Withholding and Other Payroll Forms

Federal Tax Withholding Form W-4

New York State Tax Withholding Form IT-2104

New York State Tax Exempt Form IT-2104e

Direct Deposit 

Change of Address

Holiday Waiver


Tuition Assistance

Tuition Assistance Application

UUP Waiver Registration

Employee Mandatory Fee Waiver Request


UUP Individual Development Awards

Supplemental Information Form

Exit Process Forms

Responsibilities During Exit Process



Charge of Discrimination Form

Discrimination Complaint Procedure




Additional Info

About the Area
Campus Safety Report
Dual Career Assistance
Driver Approval Process
Ethics in State Government
GOER Online Courses
Info for Distance Learning Faculty
Mail Handling Protocols
Notary Public Officers

Resources and Organizations
Retiree Organization
Staff Development
SUNY HR Web Site
SUNY Policies of Board of Trustees
Supervisors Guide to Counseling
Violence & Harassment Prevention

PDF Icon Faculty & Staff Handbook

Contact Info
P: 607-746-4495 
F: 607-746-4158



Last Updated: 10/21/16