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Forms & Documents

Instructions

For those forms which are in Word format (.doc) or Excel format (.xls), you may:

• Left click on a form title,
• Fill out the form,
• Save it to your hard drive, and then
• Email the saved document to HR at nuhr@norwich.edu

Or, if you prefer, you may simply save the document to your hard drive and work from there.

For those forms which are in portable document format (.pdf), you should click on the form title, print out the form, complete it by hand, and send it to the Human Resources Office via intracampus mail.

Contact Information

• Employment Application
• Address/Name Change

Benefit Forms and Information

Claim Forms

• Dependent Care Flexible Spending Account Plan Claim
• Health Care Flexible Spending Account Plan Claim
• Health Savings Account Accelerated Deposit Request
• Health Savings Account Salary Reduction Agreement Change & Revocation
• Dental Claim

Tuition Benefit

• Tuition Scholarship Application
• Tuition Exchange Benefit Checklist

Retirement Plan

• Defined Contribution Retirement and TDA Plans Salary Reduction Agreement

Cafeteria Plan

• Cafeteria Plan Change of Status Request
• Cafeteria Plan Online Enrollment Instructions
• Explanation, Information and Worksheet Book

Leaves of Absence

• Family & Medical Leave Policy, Application for Leave of Absence, Certification of Health Care Provider

Health Plan Informational Materials

• Blue Cross Blue Shield Frequently Asked Questions
• Blue Cross Blue Shield 24-Hour Nurse Line Informational Brochure
• Blue Cross Blue Shield 24-Hour Nurse Line Flyer
• Blue Cross Blue Shield Road To Better Health Informational Brochure
• Employee Declaration of Health Care — VT DOL Form HC-2

Employee Forms and Information

• Cellular Phone Authorization & Reimbursement
• Direct Deposit Authorization Form
• Employment Eligibility Verification (I9)
• Equal Employment Opportunity Commission form
• Federal W-4 form
• Form W-4 VT
• Human Resources Data Sheet
• Instructions for Completing form W-4 VT
• Nonexempt Employee (Hourly) Time Report
• Non-discrimination and Sexual Assault/Misconduct
• Student bi-weekly timesheet
• Student payroll schedule

Benefit Synopsis and Employment Information

• Human Resources, Payroll, and Benefit Programs Synopsis for employees

Forms for Department Heads and Managers

Faculty Hiring

• Request for Full-Time Faculty Contract
• Request for Part-Time Faculty Contract
• Request for SGS Adjunct Faculty Contract

Staff Hiring

• Authorization for Employment
• Background Check
• Motor Vehicle Records Check (interim)
• Faculty or Staff Position Budget Request (Request for New Position)
• New Employee Orientation
• Personnel/Payroll Employee Action Notice
• Performance Appraisal
• Performance Management
• Position Description: Part I
• Position Description: Part II - Summary (PAQ)
• Request for Banner Finance Grants
• Request to Open Position for Hiring

Termination

• Termination Checklist