|
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Confidentiality Statement for Academic Professionals (Unit 4) |
|
https://hsu.link/confidentiality-unit4 |
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Voluntary Self-Identification For Applicants |
|
 voluntary_self_id_form.pdf |
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Employee's Claim Form For Worker's Compensation Benefits |
|
dwc_1.pdf |
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MPP Justification Form |
|
 mpp_justification_form1.docx |
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Vice Presidents Evaluations - Administrative Review Form |
|
vp_evaluation.pdf |
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Form 109 Report of Separation Form Submission Guide |
|
form_109_report_of_separation_form_submission_guide.pdf |
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|
SPSL Request Form: Expanded Version |
|
spsl_2022_req_form_non-represented_ee.pdf |
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HSU Authorization to Release Medical Records |
|
authorization_to_release_medical_records.pdf |
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Benefit Enrollment Worksheet |
|
benefits_enrollment_worksheet_082022.pdf |
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Employee Fee Waiver - Frequently Asked Questions |
|
csufeewaiverprogramfrequentlyaskedquestions_june2016_0.pdf |
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Confidentiality Acknowledgement & Agreement for Search/Screening Committee Members and Department Support Staff (Academic Dean/Associate Dean) |
|
confidentialityacknowledgement_deanassociatedean.pdf |
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Social Security: Replacement card/name change application. |
|
http://www.ssa.gov/online/ss-5.html |
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SPSL Request Form |
|
spsl_2022_req_form_represented_ee.pdf |
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Letter/Options for Sanders Voluntary Insurances |
|
final_letter_to_covered_employees.pdf |
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Confidential Employee Evaluations - Temporary Employee |
|
temporary_employee_evaluation-confidential.pdf |
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Social Security Office- Replacement card/name change application |
|
http://www.ssa.gov/online/ss-5.html |
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Sponsored Programs Foundation (SPF) Benefits for Eligible Employees |
|
spf-new_employee_handout-benefit_eligible_1.pdf |
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Humboldt Accommodation Request Form |
|
accommodation_request_form.pdf |
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Employee Assistance Program (EAP) |
|
eap_0.pdf |
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Confidential Employee Evaluations - Probationary Employee Evaluation |
|
https://hsu.link/prob-eval-confidential |
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Social Security & Your Retirement |
|
seminarhsu.pdf |
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Outside Employment Disclosure Form (Appendix G) |
|
appendix_g_-_outside_employment_disclosure_form.pdf http://www.humboldt.edu/aps/ |
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Student Wage Schedule |
|
student_salary_ranges.pdf |
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EHOS Hot Work Permit Program |
|
hsu_hot_work_permit_program_2012.pdf |
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COBRA Rates for 2015 |
|
cobra_rates_for_2015.doc |
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Vacancy Announcement Template - Graduate Assistant (GA) |
|
unit11_ga_vacancyannouncement_template.pdf |
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Special Consultant Request Instructions |
|
specconsreq_instructions.pdf |
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Leave Without Pay (LWOP) Application (staff/management) |
|
https://hsu.link/leave_of_absence |
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Staff Compensation and Classification Request Form |
|
cal_poly_humboldt_compensation_and_classification_request_form.pdf |
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Student Payroll Action Request (SPAR) |
|
https://hsu.link/spar-updates |
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Coach Performance Evaluation Form |
|
coaching_performance_evaluation_updated_9-5-17_pdf.pdf |
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Designated Positions |
|
hr2011-02attb.pdf |
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Unit 1 - UAPD (Union of American Physicians and Dentists) - Permanent Employee Evaluation |
|
https://hsu.link/perm-eval-unit1 |
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How Service Credit is Earned |
|
service_credit_breakdown.pdf |
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Quick Guide to Logging Your Steps |
|
quick_guide_to_logging_your_steps.pdf |
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Units 2, 5, 7 & 9 - CSUEU - Permanent Employee Evaluation |
|
https://hsu.link/perm-eval-units2579 |
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Housing & Dining Services Separating Employee Clearance Form |
|
separatingemployeeclearanceform_housing.pdf |
|
|
Cal Poly Humboldt Volunteer Form |
|
https://hsu.link/volunteerform |
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|
APS Applicant Spreadsheet - Temporary Faculty Pool |
|
 tempfacpoolapplicantss.xls |
|
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Domestic Partner Information |
|
taxationofdomesticpartnershipbenefits-after11-08_0.pdf |
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Dental Plan Enrollment Authorization |
|
csu_dental_form.pdf |
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|
Please Delete |
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|
|
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Unit 4 - APC (Academic Professionals of California) - Annual Employee Evaluation |
|
https://hsu.link/eval-unit4 |
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|
Hints for completing the SPAR form |
|
hints_for_completing_the_spar_form.pdf |
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ISA & ISA Work Study - Covid19 |
|
covid_19_isa_isa_work_study.xlsx |
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APS Applicant Spreadsheet - Dean Searches |
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|
|
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Student Assistant Performance Evaluation |
|
student_assistant_performance_evaluation_form.pdf |
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Domestic Partner Forms |
|
formsdomesticpartnerbenefits_0.pdf |
|
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Separating Employee Clearance Form |
|
separating_employee_clearnance_form_2023_v7.pdf |
|
|
Defense of Marriage Act Updates |
|
defense_of_marriage_act_0.pdf |
|
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Unit 6 - SETC (State Employee Trades Council) - Permanent Employee Evaluation |
|
https://hsu.link/perm-eval-unit6 |
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Highlights of New Voluntary Plans |
|
pages_from_tl-ben2011-02.pdf |
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Student Assistant & Work Study - Covid19 |
|
student_assistant_work_study.xls |
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APS Applicant Spreadsheet |
|
applicantss.xls |
|
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Discrimination Complaint Resources |
|
complaint_resources.pdf |
|
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University Police Department (Live Scan/Fingerprinting Information) |
|
http://www2.humboldt.edu/police/live-scan |
|
|
Unit 8 - SUPA (Statewide University Police Association) - Permanent Employee Evaluation |
|
https://hsu.link/perm-eval-unit8 |
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Application Procedures for Leave of Absence without Pay |
|
leaveofabsencewithoutpay_procedure_0.pdf |
|
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Close Relative Disclosure Form |
|
close_relative_disclosure_form_0.pdf |
|
|
Universal Availability Notice 2014 |
|
universal_availability_notice_-2014_plan_year.pdf |
|
|
Confidential Employee Evaluations - Permanent Employee Evaluation |
|
https://hsu.link/perm-eval-confidential |
|
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Health Care/Dependent/Care Reimbursement Account Claim Form |
|
claim_form.pdf |
|
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Statement Concerning Your Employment in a Job Not Covered by Social Security |
|
ssa-1945_0_0-3.pdf |
|
|
Universal Availability Notice - 403(b) Plan Information |
|
universal_availability_notice-_final_20121218.pdf |
|
|
Management Personnel Plan Performance Evaluation (MPP) - Management Personnel Plan Performance Evaluation |
|
https://hsu.link/mppannualevals |
|
|
IRB Registration Form |
|
http://www.humboldt.edu/human_subjects/images/pdfs/IRB_Registration.pdf |
|
|
Units 2, 5, 7 & 9 - CSUEU - Temporary Employee Evaluation |
|
https://hsu.link/temp-eval-unit2579 |
|
|
Units 2, 5, 7 & 9 - CSUEU - Probationary Employee Evaluation |
|
https://hsu.link/prob-eval-units2579 |
|
|
Privacy Notice - Employee Assistance Program |
|
october_2014_eap_notice.pdf |
|
|
Unit 8 - SUPA (Statewide University Police Association) - Temporary Employee Evaluation |
|
https://hsu.link/temp-eval-unit8 |
|
|
Form 1: Authorization to Recruit (Academic Dean/Associate Dean) |
|
form1_authorizationtorecruit_deanassociatedean_fillable.pdf |
|
|
Offer of Appointment within 5% of Minimum Range (Form 5) |
|
form_5_within5percent.pdf |
|
|
DELETE PLEASE |
|
|
|
|
Pregnancy Disability Certification |
|
pregnancy_disability_certification.pdf |
|
|
Staff Evaluation Forms |
|
http://www.humboldt.edu/hsuhr/employee/evaluation/index.html |
|
|
Unit 8 - SUPA (Statewide University Police Association) - Probationary Employee Evaluation |
|
https://hsu.link/prob-eval-unit8 |
|
|
Form 109 Report of Separation Approval Guide |
|
form_109_report_of_separation_approval_guide.pdf |
|
|
Executive Summary - 2012 Campus Dialogue on Race |
|
executivesummary-2012campusdialogueonrace.pdf |
|
|
Required Notification for Employees Not Covered by Social Security (SSA-1945 Form) |
|
ssa-1945.pdf |
|
|
Unit 6 - SETC (State Employee Trades Council) - Temporary Employee Evaluation |
|
https://hsu.link/temp-eval-unit6 |
|
|
Everyday Preventive |
|
everyday_preventive_002.pdf |
|
|
Travel Exception Request Form |
|
https://na2.documents.adobe.com/account/customComposeJs?&workflowid=CBJCHBCAA... |
|
|
CSU Fee Waiver Program Information |
|
http://www.humboldt.edu/hsuhr/employee/waiver/index.html |
|
|
Unit 6 - SETC (State Employee Trades Council) - Probationary Employee Evaluation |
|
https://hsu.link/prob-eval-unit6 |
|
|
Every Step Counts! Campus Map |
|
campusmap2_0.pdf |
|
|
New Employee Checklist |
|
new_empl_check_list.doc |
|
|
CSU Family Medical Leave (FML) |
|
csufamilymedicalleave-generalnotice_000_0.pdf |
|
|
Grant Furlough Exemption Form |
|
furloughexemptionform_000.pdf |
|
|
Position Description/Classification Guide |
|
https://hraps.humboldt.edu/position-description-classification-process |
|
|
Screening Matrix |
|
application_-_screening_matrix_-_asa.xls |
|
|
Unit 4 - APC (Academic Professionals of California) - Unit 4 Employee Evaluation |
|
https://hsu.link/eval-unit4 |
|
|
CSU Employee Benefits Summaries - Faculty (Unit 3) |
|
cfa_unit_3_benefits_summary.pdf |
|
|
Position Description Form |
|
position_description_template1.docx |
|
|
HSU Overview of Reasonable Accommodation |
|
overview_of_reasonable_accommodation.pdf |
|
|
Request for Service Credit - Service Prior to Membership |
|
request_for_service_credit_cost_information-_service_prior_to_membership.pdf |
|
|
Saving Made Easy - 403(b) Information |
|
saving_made_easy_brochure_2014.pdf |
|
|
Unit 1 - UAPD (Union of American Physicians and Dentists) - Temporary Employee Evaluation |
|
https://hsu.link/temp-eval-unit1 |
|
|
Designation of Person Authorized to Receive Pay |
|
payrolldesignee.pdf |
|
|
Event Planning Form |
|
rm_-_event_planning_form.pdf |
|
|
Workers' Compensation for Students |
|
student_work._comp_guide.doc |
|
|
Career Development Plan |
|
https://apex.humboldt.edu/ords/f?p=244:3 |
|
|
Sabbatical/DIP Notary Pages |
|
notary_pages-leaves.pdf http://www.humboldt.edu/aps/policies/leaves.html |
|
|
Unit 1 - UAPD (Union of American Physicians and Dentists) - Probationary Employee Evaluation |
|
https://hsu.link/prob-eval-unit1 |
|
|
Contract Credit Registration Form - fillable PDF |
|
http://www.humboldt.edu/extended/pdf/regform-contract-credit.pdf |
|
|
MPP Outside Employment Disclosure Form (HR 2016-06 & Attachment A) |
|
hr_2016-06_and_attachment_a_-_mpp_outside_employment_disclosure_form.pdf |
|
|
HSU Job Duty Evaluation Checklist |
|
job_duty_evaluation_checklist.pdf |
|
|
Request for Live Scan Service Form (Fingerprinting) |
|
live_scan_form_bcia_8016_20211026.pdf |
|
|
DELETE PLEASE |
|
|
|
|
CalPERS Member Reciprocal Self-Certification Form |
|
https://www.calpers.ca.gov/docs/forms-publications/self-certification.pdf |
|
|
Understanding Your State of California Pay Warrant |
|
understanding_your_state_of_california_pay_warrant.pdf |
|
|
Workers Compensation Pre-Designation of Physician Form |
|
noticetonewemployeeswebsiteonly.doc |
|
|
HSU Guidelines for Evaluating Impairments |
|
guidelines_for_evaluating_impairments.pdf |
|
|
DELETE PLEASE |
|
|
|
|
EO 1097 Student Affirmative Action Complaints Actions Resources Table |
|
student-applicant_complaint_resources.pdf |
|
|
Work-Related Injury Reporting Procedure |
|
work_related_injury_reporting_procedures.pdf |
|
|
CalPERS Beneficiary Designation Form |
|
http://www.humboldt.edu/hsuhr/docs/benedesignee.pdf |
|
|
RM - Field Trip Sign Out Release Agreement |
|
rm_-_sign_out_release_agreement.doc |
|
|
HSU Green and Gold Calendar for 2011-2012 |
|
greenandgoldcalendar_2011-2012.pdf |
|
|
Conviction Disclosure Form |
|
conviction_disclosure_form.pdf |
|
|
Whistleblower Complaint Form |
|
whistleblower_complaint_form.pdf |
|
|
HSU Green and Gold Calendar for 2010-2011 |
|
hsu_greenandgoldcalendar_2010-2011.pdf |
|
|
Retirement Information |
|
retirement.pdf |
|
|
TRiO UB Resident Mentor Application 2015 |
|
trio_ub_rm_packet_2015.pdf |
|
|
PERS Declaration of Health Benefits |
|
pers_declaration_of_health_hbd12a.pdf |
|
|
HSU Employment Application |
|
employment_application_packet_v16_9-2016.pdf |
|
|
HSU's Office of Research Spring 2019 Newsletter |
|
hsus_office_of_research_newsletter_-_spring_2019.pdf |
|
|
Instructions to Complete Digital Signature on Position Change Form |
|
digital_signature_instructions.pdf |
|
|
VSP Vision Insurance Claim - No form required for vision services |
|
|
|
|
HSU Diversity Program Funding Grant: Signature Form |
|
signature_2016.pdf http://diversity.humboldt.edu/content/diversity-equity-grants-grant-forms-use... |
|
|
Confidentiality Statement for Faculty |
|
https://hsu.link/confidentiality-faculty |
|
|
Special Consultant Request |
|
special_consultant_form.pdf |
|
|
VSP Video Display Terminal (VDT) Claim Form |
|
vsp_video_display_terminal_claim_form.pdf |
|
|
Performance Pay Salary Increase Recommendation - Unit 4 |
|
http://www.humboldt.edu/hsuhr/employee/information/unit4.html |
|
|
Employment Release of Information Form |
|
release_of_information_form.pdf |
|
|
Confidentiality Statement for Employees, Consultants, and Independent Contractors |
|
https://hsu.link/confidentiality-staff |
|
|
VSP Out-of-Network Reimbursement Form |
|
vsp_out_of_network_reimbursement_form-2.pdf |
|
|
Rehired Annuitant Certification |
|
rehired_annuitant_certification-ui.pdf |
|
|
Instructional Observation Checklist |
|
instructional_observation_checklist.pdf |
|
|
Biometric Screening Quick Guide |
|
maximwellness_registration_calpers_2014_2.pdf |
|
APS |
Application for Academic Employment |
|
academic_employment_application.pdf |
|
APS Confidentiality Form (Faculty Unit Positions) |
Confidentiality Acknowledgement & Agreement for Search/Screening Committee Members and Department Support Staff (Faculty Unit Positions) |
|
confidentialityacknowledgement_facultyunit_revised_10.14.2022.pdf |
|
APS Form 1 - Probationary |
Form 1: Authorization to Recruit (Probationary Faculty) |
|
form1_authorizationtorecruit_probationaryfaculty_revised_09.17.2019_fillable.pdf |
|
APS Form 1 - Temp Fac |
Form 1: Request and Authorization to Recruit (Temporary Faculty Unit Employees) |
|
form1_requestauthorizationtorecruit_tempfaculty_fillable.pdf |
|
APS Form 1 - Visiting |
Form 1 - Request to Recruit Visiting Faculty |
|
form1_requestauthorizationtorecruit_visitingfaculty_fillable.pdf |
|
APS Form 2 |
Form 2: Confidential Applicant Log |
|
form2_applicantlog_revised_11.05.2019.xlsx |
|
APS Form 230 |
Form 230 - Visiting Faculty Position Request |
|
form230_visitingfaculty.xls |
|
APS Form 3 |
Form 3 - Interview Request |
|
form3.xlsx |
|
APS Form 3 - Dean |
Form 3: Interview Request (Academic Dean/Associate Dean) |
|
form3_interviewrequest_deanassociatedean.pdf |
|
APS Form 300 |
Application for Leave Without Pay |
|
|
|
APS Form 4 - Academic Dean |
Form 4: Recommendation to Provost (Academic Dean) |
|
form4_recommendationtoprovost_dean_fillable.pdf |
|
APS Form 4 - Associate Dean |
Form 4: Recommendation to Provost (Academic Associate Dean) |
|
form4_recommendationtoprovost_associatedean_fillable.pdf |
|
APS Form 4 - Probationary Faculty |
Form 4: Recommendation Report to Dean/Director (Probationary Faculty) |
|
form4_recommendationtodeandirector-probationaryfaculty_fillable.pdf |
|
APS Form 4 - Temporary Faculty |
Form 4: Recommendation Report to Dean/Director (Temporary Faculty Unit Employees) |
|
form4_recommendationtodean_tempfaculty_fillable.pdf |
|
APS Form 400 |
Form 400: Recommendation for Faculty Unit Appointment (Tenure-Line) |
|
form400_recommendationforfacultyunitappointment_tenure-line_fillable.pdf |
|
APS Form 430 |
Form 430: Application for Market Increase with Bona Fide Offer |
|
form_430_application_for_market_increase_with_bona_fide_offer.pdf |
|
APS Form 450 |
Form 450 - Probationary/Tenured Faculty Workload Distribution Form |
|
form450_workloaddistribution.pdf |
|
APS Form 5 (Dean/Associate Dean) |
Form 5: Request to Offer Appointment - Dean/Associate Dean |
|
form5_requesttoofferappointment_deanassociatedean_fillable.pdf |
|
APS Form 5 - Probationary Faculty |
Form 5: Request to Offer Appointment (Probationary Faculty Unit Employees) |
|
form5_requesttoofferappointment_probationaryfaculty_fillable.pdf |
|
APS Form 5 - Temp Fac |
Form 5: Request to Offer Appointment (Temporary Faculty Unit Employees) |
|
form5_requesttoofferappointment_tempfaculty_fillable.pdf |
|
APS Form 505 |
Form 505 - Non-Incumbent Lecturer Justification Form |
|
form505_lecturerjustification.pdf |
|
APS Form 510 |
Advice of Separation: Lecturer, FERP, TA & GA |
|
form510_separation.xlsx |
|
APS Form 515 |
Advice of Separation: Coaches, Counselors (SSP-AR & Interns), Librarians |
|
form515_separation-coach-sspar-librarian.xlsx |
|
APS Form 540 |
Form 540: Temporary Librarian Transaction Form |
|
form540_templibappt.pdf |
|
APS Form 560 |
Form 560 - Temporary Counselor Transaction Form |
|
form560_temp_counseling_appt.xls |
|
APS Form 570 |
Form 570: Substitute Faculty Assignment |
|
form570_substitutefac_3.10.2023.pdf |
|
APS Form 580 |
Form 580: Application for Lecturer Appointment |
|
form580_applicationlecturerappt.pdf |
|
APS Form 590 |
Form 590: Application for Temporary Appointment - Coaches/Counselors/Librarians |
|
form590_application_athl-caps-lib_1.2.18_fillable.pdf http://www.humboldt.edu/aps/employment/pool.html |
|
APS Form 595 |
Form 595: Request for Subsequent Appointment - Coaches/Counselors/Librarians |
|
form595_requestsubsequent_athl-caps-lib_fillable.pdf http://www.humboldt.edu/aps/employment/pool.html |
|
APS Form 600 - ISA |
Form 600: Instructional Student Assistant (ISA) Appointment Form |
|
https://apex.humboldt.edu/ords/f?p=246:1 |
|
APS Form 610 |
Advice of Separation: Instructional Student Assistants |
|
form610_isa_separation_updated.pdf |
|
APS Form 630 |
Form 630: Description of Duties |
|
form630_unit11_description_of_duties_final_1.pdf |
|
APS Form 640 |
Form 640: Unit 11 Evaluation Criteria |
|
form640_unit11_evaluation_criteria_final.pdf |
|
APS Form 800 |
Form 800 - Volunteer Faculty: Recommendation for Appointment |
|
form800_volunteerfacultyid.xls |
|
APS Form 900 |
Form 900 - Request for Participation in Faculty Early Retirement Program (FERP) |
|
form900_ferp_partic_req_2023_update.pdf |
|
APS Form 910 |
Form 910 - Visiting Faculty Request to Offer Appointment |
|
form910_visitingfac.xls |
|
APS PE & MPR |
Periodic Evaluation and Modified Performance Review Coverpage |
|
pe-mpr_coverpage_probationary.pdf |
|
APS RTP WPAF1 |
WPAF Coverpage - Probationary |
|
wpaf_coverpage_probationary.pdf http://www.humboldt.edu/aps/faculty/retention.html |
|
APS Strategic Advertising & Recruitment Plan |
Strategic Advertising & Recruitment Plan |
|
strategicadvertisingrecruitmentplan_revised_5.12.2023.pdf |
|
Form 104 |
Report of Appointment for Special Consultants |
|
https://apex.humboldt.edu/ords/f?p=247:1 |
|
Form 109 |
Report of Separation for Staff - (Electronic) |
|
https://apex.humboldt.edu/ords/f?p=248:1 |
|
Form 3 |
Staff Form 3: Interview Request |
|
staff_form_3.pdf |
|
Form 4 |
Selection Committee Hiring Recommendation (Form 4) |
|
form_4.pdf |
|
Form 5 |
Request to Vice President to Offer Appointment-Over 5% of Minimum Range (Form 5) |
|
form_5_over5percent.pdf |
|
I-9 |
Employee Eligibility Verification |
|
http://www.uscis.gov/files/form/i-9.pdf |
|
N/A |
Form 200: Position Request (Probationary Faculty) |
|
|
|
RTP PDP |
Professional Development Plan Form (PDP) |
|
professionaldevelopmentplan_1.docx http://www.humboldt.edu/aps/faculty/retention.html |
|
RTP WPAF2 |
WPAF Coverpage - Tenured |
|
wpaf_coverpage_tenured.pdf http://www.humboldt.edu/aps/faculty/retention.html |
|
STD-699 |
Direct Deposit Form |
|
https://hsu.link/direct-deposit |
|
TA Vacancy |
Vacancy Announcement Template - Teaching Associate (TA) |
|
unit11_ta_vacancyannouncement_template.pdf |
|
Vac Template - Prob Fac |
Vacancy Announcement Template - Probationary Faculty Unit Employee |
|
probationary_vacancy_template_2023-24_final.docx |
|
Vac Template - Temp Fac |
Vacancy Announcement Template - Temporary Faculty Unit Employee |
|
ft_or_pt_tempfaculty_vacancy_template_2023-24.docx |
|
W-4 |
W-4 - Employee's Witholding Allowance Certificate |
|
http://www.irs.gov/pub/irs-pdf/fw4.pdf |
