Forms

New Digital HR Status Form

Please visit our HR Status Form Resource Page in order to fill out and submit the new digital HR Status Form for all employee actions (Hires, Changes, Terminations).

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

All Non-Affiliate new hires will be sent their New Hire Paperwork via DocuSign from the Talent Acquisition Team in Human Resources.  In order to have this paperwork sent to the New Hire, a Digital HR Status Form or PT Faculty Appointment Form must be submitted through their proper channels.  Any questions around the New Hire Process can be sent to Kyle Smith, Director of Talent Acquisition.

General Employment

• Name Change Form (PDF) (Revised 12/2023)
• Part-Time Faculty Appointment Form (PDF)
• Federal Tax Form (W-4) (PDF)
• State Tax Form (WH-4) (PDF)
• Pay Schedule Form (PDF)
• Payroll: Direct Deposit Authorization Form (PDF)

Tuition Remission

• Tuition Remission Authorization formYou will need to be logged into Google with your Butler credentials.

Recruiting​

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

Onboarding/Exiting Resources

• Employee Exit Checklist (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)
• Butler University Employee Wellness Incentive Form