Please direct questions regarding attendance/leave/time reporting to Human Resources.
FMLA Doctor's Certification Form - EmployeesFMLA Doctor's Certification Form - Family MemberPASSHE Request to Donate Leave FormTime Sheet - Hourly EmployeesTime Sheet - InternTime Sheet - Permanent EmployeesVideo: How to Complete an Hourly Employee Time SheetVideo: How to Complete an Intern Time Sheet
Please direct questions regarding benefits to Human Resources.
Management Benefits Enrollment FormName Change Request FormAFSCME - PEBTF Coordination of Benefits FormPEBTF Enrollment / Change Form
Additional benefits information and forms can be found on the PASSHE System Human Resources page.
Please direct questions regarding hiring/recruitment to Human Resources.
Prior Commonwealth Service FormPosition Authorization FormI-9 Form 2013PASSHE Moving Expense Repayment Agreement
Please direct questions regarding insurance to Beth Frey or
MaryAnn Spontak in HR.
Address Change Request FormEmployee Emergency Contact Data Form
Please direct questions regarding payroll to Frank Lentz in HR.
2011 W4 FormDirect Deposit Authorization FormEarned Income Wage Tax Residency Certification Form
Please direct questions regarding classification to Rahmaan Simpkins in HR and
questions regarding recruitment to Human Resources
Position Description TemplatePosition Authorization Form
Please direct questions regarding retirement to Human Resources
Retirement Program Election FormAlternative Retirement Plan (ARP) Allocation Change Form
Additional retirement information and forms can be found on the PASSHE System Human Resources page.
Please direct questions regarding safety to Human Resources.
Work Related Injury or Accident Form
Please direct questions regarding training to Human Resources.
AFSCME Application for Tuition Waiver BenefitManagement Application for Tuition WaiverOST Authorization Form for Credit Bearing CourseEmployee Request to Pursue a Degree Program Form