HR Forms

COVID-19 Health Screening

• Health Screening Survey Form (English)
• Health Screening Survey Form (Spanish)

ADA Process Forms

• Notice of ADA Conference
• Request for Accommodation 504 ADA
• Section 504 ADA Conference Report Form

Affiliate Forms

• Affiliate University ID Request Form (DOC)
• Affiliate Code of Responsibility Form  (PDF) 

New Hire Faculty/Staff Forms

• I-9 Employment Eligibility Form 
• New Employee Information Form
• Code of Responsibility
• Policy Acknowledgment
• Voluntary Self-Identification of Disability
• Voluntary Self-Identification of Protected Veteran Status
• Pay Schedule Form (full-time employees only)
• Federal Tax Form (W-4)
• State Tax Form (WH-4)
• Payroll: Direct Deposit Authorization Form

General Employment

• Name Change Form (PDF) 
• Part-Time Faculty Appointment Form (DOC)

Tuition Remission

• Tuition Remission Authorization form (fillable PDF)

Recruiting​

• Faculty Position Request Form (PDF)
• Faculty Position Justification Form (DOC)

Onboarding/Exiting Resources

• Employee Exit Checklist (PDF)
• Faculty / Staff Status Form (XLSX fillable form with drop-down menus)​
• Job Aid for Faculty/Staff Status Form (PDF)
• One America Life Insurance Coverage Portability and Conversion (PDF)

Other Resources

• Incident Report Form (PDF)
• Personal Computer Loan Program Certification Sheet (PDF)
• Flexible Work Time Request Form (PDF)
• 2020 Butler University Employee Wellness Incentive Form