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Forms

The following is a list of the most frequently-used forms in Human Resources, listed by category. If you need assistance, feel free to contact us.

 

Employment File Format
New Hire Forms (for Staff) PDF
New Hire Forms (for Faculty) PDF
Employment Eligibility Verification Form (Form I-9) PDF
Background Screening Request Form PDF
Hohenstein Programs PAR PDF
Introductory Assessment Form PDF
Living Pepperdine Introductory Assessment Form PDF
New FTE/Position Request (Add a New Position/FTE to a Department) PDF
Service/Maintenance/Skilled Crafts PDQ WORD 
Restricted/Transfer Request (Hire for a restricted or non-posted position) PDF
Staff Change Request (Change an existing position/employee job record) PDF
Temporary Hire Request Form (Hire or extend temporary staff) PDF

  * Please contact Human Resources regarding position descriptions and job posting requests.

Benefits File Format
Blue Cross Patient Claim Form PDF
Faculty/Staff Dependent Form LINK
Family Leave (FMLA/CFRA) Application PDF
Family Leave (FMLA/CFRA) Doctor's Certification Form PDF
PayFlex FSA Claim Form PDF
VSP Vision Plan Out of Network Reimbursement Form PDF
State Disability Claim Instructions LINK
State Disability Claim Form LINK
Tuition Remission LINK
Waiver of Group Medical Coverage PDF
Wellness PPAC Calendar WORD

  

Workers Compensation File Format
Employee's Claim for Worker's Compensation Benefits PDF
Employer's Report of Occupational Injury or Illness PDF
Supervisors Accident/Incident Investigation PDF

 

Performance Assessment File Format
Annual Employee Assessment Form PDF
Annual Career Development Review Form WORD
Notes on Performance Assessment Interview PDF
Supplemental Evaluation Form WORD

 

Other File Format
Consultant Services Agreement WORD
PeopleSoft Human Resources Access Application PDF
Person of Interest Form LINK
Conducting an Investigation PDF
Telecommuting Procedures PDF
Telecommuting Agreement PDF