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Forms Library

MS documents (.doc) Adobe Acrobat files (.pdf)
 
BENEFIT FORMS
Affidavit of Domestic Partnership (not available in Word) Affidavit of Domestic Partnership* (37k)
Classified/Management Insurance Enrollment Form Classified/Management Insurance Enrollment Form * (37k)
Faculty Insurance Enrollment Form (72k) Faculty Insurance Enrollment Form * (61k)
Salary Reduction Agreement-403 (b) Salary Reduction Agreement-403 (b)
Salary Reduction Agreement-457(b)  (45k) Salary Reduction Agreement-457(b) *(74k)
Section 125 Enrollment Form (86k) Section 125 Enrollment Form * (58k)
Section 125 Reimbursement Form (not available in Word) Section 125 Reimbursement Form
Tuition Waiver - family (43k) Tuition Waiver - family *(24k)
Tuition Waiver - part time or other Qualifying Category (46k) Tuition Waiver - part time or other Qualifying Category *(34k)
Tuition Waiver - retired (23k) Tuition Waiver - retired *(11k)
 
PAYROLL FORMS
Classified Annual Worksheet (.xls) (60k) Classified Annual Worksheet (not available in PDF)
Confidentiality Statement (32k) Confidentiality Statement *(136k) 
Direct Deposit (42k) Direct Deposit *(29k)
Form I-9 (not available in Word) Form I-9 *
Form W-4 (not available in Word) Form W-4 *
FERPA (The Family Educational Rights and Privacy Act of 1974) Form (32k) FERPA (The Family Educational Rights and Privacy Act of 1974) Form *(15k)
Journal Entries (30k) Journal Entries *(1k)
Personal Information Form (35k) Personal Information Form * (35k)
Personnel Action Form (71k) Personnel Action Form *(71k) 
Personal Cell Phone Allowance (33k) Personal Cell Phone Allowance * (36k) 
Student Worker Template (70k) Student Worker Template * (45k)
Vacation Payout Request Form (137k) Vacation Payout Request Form *(88k)
Volunteer Waiver of Liability (130k) Volunteer Waiver of Liability *(20k)
   
RECRUITMENT FORMS
Employment Recommendation Form (36k) Employment Recommendation Form * (60k)
Recruitment Report (39k) Recruitment Report*(50k)
Search Committee Agreement Form (42k)

Search Committee Agreement Form *(103k)

Search Committee Confidentiality Form (47k) Search Committee Confidentiality Form *(74k)
Temporary Appointment Recommendation (143k) Temporary Appointment Recommendation *(56k)
   
CLASSIFIED FORMS
Classification Review Form (15k) Classification Review Form (27k)
Classified Evaluation (32k) Classified Evaluation *(122k) 
Classified Rating Scale Definitions (33k) Classified Rating Scale Definitions * (15k)
Job Description Questionnaire (31k) Job Description Questionnaire *(84k)
 
FACULTY FORMS
Faculty Certification Form (not available in Word) Faculty Certification Form *
Faculty Developmental Evaluation Checklist (57k) Faculty Developmental Evaluation Checklist *(54k)
Faculty Evaluation handbook (127k)  Faculty Evaluation handbook *(148k)
Faculty Insurance Enrollment Form (72k) Faculty Insurance Enrollment Form * (61k)
Faculty Leave & Substitution Calculation - Article 32.6 (20.5) Faculty Leave & Substitution Calculation - Article 32.6  * (21k)
Faculty Pay Plan Change Request (130k) Faculty Pay Plan Change Request * (38k)
Faculty Step Advancement Handbook (345k) Faculty Step Advancement Handbook * (137k)
Full Load Equivalency (20k) Full Load Equivalency * (16k)
Overload Form for Contracted Faculty (26k) Overload Form for Contracted Faculty * (23k)
Request for RIF report review form (37k) Request for RIF report review form *(10k)
   
PART TIME FACULTY FORMS
Part Time Cancellation Process-Article 34.8 (31k) Part Time Cancellation Process - Article 34.8 * (25k)
Part Time Faculty Evaluation Record Sheet (51k) Part Time Faculty Evaluation Record Sheet   *(18k)
Part Time Faculty Insurance Enrollment Form (72k) Part Time Faculty Insurance Enrollment Form * (61k)
Part Time Placement form (143k) Part Time Placement form *(19k)
Part Time Statement of Appointment (81k) Part Time Statement of Appointment *(63k)
Part Time Statement of Appointment - with Fall Inservice (48k) Part Time Statement of Appointment - with Fall Inservice *(23k)
Part Time Work Assignment- Article 34.2 (36k) Part Time Work Assignment - Article 34.2 * (24k)
   
MANAGEMENT FORMS
Managers Performance Review Rating Scale Definition (31k) Managers Performance Review Rating Scale Definition * (118k)
Performance Review Instrument Performance Review Instrument (not available in PDF)
   
ADA FORMS
Medical Inquiry Form (ADA) (49k) Medical Inquiry Form (ADA)* (77k)
Request for Accommodation (ADA) Form(39k) Request for Accommodation Form (ADA)* (73k)
 
LEAVE OF ABSENCE/OFLA/FMLA FORMS
Health Care Provider Certification Form (184k) Health Care Provider Certification Form * (29k)
Leave Of Absence request (35k) Leave of Absence Request * (47k)
Request for Medical and Family Leave Form (174k) Request for Medical and Family Leave Form * (42k)
Sick Child Leave Notification (152k) Sick Child Leave Notification *(77k)
 
SAFETY FORMS
Employee Accident/Incident Analysis Form (63k) Employee Accident/Incident Analysis Form * (19k)
Workers' Compensation 801 Form (not available in Word) Workers' Compensation 801 Form * (75k)
 
PERS FORMS
One Time Variable Transfer: Active or Inactive Member (not available in Word) One Time Variable Transfer: Active or Inactive Member (154k)*
Designation of Beneficiary: Tier One or Tier Two Member (not available in Word) Designation of Beneficiary: Tier One or Tier Two Member (205k)*
Designation of Beneficiary: IAP (not available in Word) Designation of Beneficiary: IAP (296k)*
Estimate Request: Tier One or Tier Two Member (not available in Word) Estimate Request: Tier One or Tier Two Member (327k)*
Estimate Request: OPSRP Member (not available in Word) Estimate Request: OPSRP Member (117k)*

* (.pdf - requires Adobe Acrobat Reader)

Lane Community College is an equal opportunity/affirmative action institution.

 

Affirmative Action / Equal Opportunity | Diversity | Professional and Organizational Development

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Lane Community College - Human Resources - 4000 East 30th Avenue, Eugene, OR 97405
Building 3 - 1st floor, Main Campus
(541) 463-5211 - fax (541) 463-3970  - TDD available at (541) 463-3999

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Revised 11/17/11 (sd)
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