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Human Resources Forms

Application for Employment

Appointment Processing Forms

Business Card Request

New Instructor Information

Off-Site Instructor Information


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)

Dependent Care

Dependent Care Advantage Account Reimbursement


SUNY Delhi Driver Information 


Evaluation, Performance Program and Annual Report Forms

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


Faculty Promotion Forms

Faculty Promotion Release Statement - pdf (fillable)

Academic Data Summary - word


Health Insurance Forms

Empire Plan Claim

Health Care Spending Account Reimbursement

Health Insurance Enrollment

Domestic Partner


Leave Forms

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

Search Forms

Hiring Process for New Positions 

Request To Fill Form

Candidate Interview Report

Hiring Procedure Report

I9: US Employment Eligibility Verification Form


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

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



Discrimination Complaint 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
Guidelines for Search Committees
Holidays 2015
Info for Distance Learning Faculty
Mail Handling Protocols
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


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Last Updated: 3/25/15