Human Resources Management and Development

Forms

Work Place Injury Reporting

Report all emergencies to the University Police at 317-940-9999
Accident/Injury Form (PDF)
Injury on Job Procedure (PDF)
U.S.HeatlhWorks locations and hours (PDF)

Report Non-employee injuries (including students, visitors, alumni, or contracted employees)to University Police Department 317-940-9396

Family & Medical Leave Act

NOTE:  the staff process to apply for and to report FMLA has changed effective January 1, 2014

Staff applying for FMLA must speak with their supervisor then contact CareWorks USA 1-888-436-9530 to obtain an application for FMLA and a Medical Certification form. 

Faculty applying for FMLA  must contact Human Resources to apply for FMLA.  JH-144 x9355 

Faculty Request for FMLA form (PDF)
Faculty Medical Certification of Health Care Provider (PDF)
Faculty Fitness for Duty (PDF)

Compensation Study - October 2005

Position Description Questionnaire (DOC)

Affiliate Forms

Request for Affiliate ID Form (PDF)
Code of Responsibility Form  (PDF)

General Employment

Address/Name Change (PDF)
Direct Deposit (PDF)
Part-time Faculty Form (DOC) with field drop down menus
Pay Schedule (PDF)
Faculty / Staff Status Form (DOC) with field drop down menus

New Hire

New Employee Information (PDF)
I-9 Employment Eligibility Form(I-9) (PDF) (Rev. 03/08/13 most recent version)
Federal Tax Form(W-4) (PDF)
State Tax Form(WH-4)  (PDF)
Direct Deposit form       (PDF)

                                                                                                                                                                                                                                                                                                                                    Code Code of Responsibility (PDF)

Performance Management Tools

Performance Evaluation Summary (DOC)
Performance Evaluation Summary - Sample (DOC)
Performance Management Guide (DOC)
Self Evaluation (DOC)

Recruiting

Position Request Form page 1 of 2 (DOC)
Position Justification Form page 2 of 2  (DOC)

NEWS

More news

Human Resources Management & Development

4600 Sunset Avenue
Jordan Hall, Room 144
Indianapolis, IN 46208
(317) 940-9355
(800) 368-6852 ext. 9355
HR Assistant: Sherri A. Heidenreich
sheidenr@butler.edu