Human Resources Forms

Forms
Adjunct Faculty Health Insurance Request Form
CalSTRS Recipient Designation Form
Dental HMO Enrollment Form
Dental PPO Enrollment Form
FSA - TASC Enrollment Form
Hartford - Voluntary Life Enrollment Form
Hartford - Voluntary Life Evidence of Insurability Form
Healthcare Certification Form
Hiring Exemption Request Form
Leave of Absence Request (FML - Family Medical Leave)
Leave of Absence Request (General)
Leave of Absence Request (PDL - Pregnancy Disability Leave)
Live Scan Request Form and Locations
Long Term Care - UNUM - Enrollment Form
Medical Waiver Form (2026)
Metlife Legal Plan Enrollment Form
Paid Sick Leave
Resignation/Retirement Workday Request Process
Student Worker Personnel Action Form Eff. 7-1-25
VEBA Medical Enrollment Form
VSP - Vision Enrollment Form