Human Resources


Contact Information

Christine Derwitsch
Assistant in Human Resources 
Davidson, Room 201
959.255.8790 (Fax)

Office Hours

Monday — Friday
8 a.m. - 5 p.m.


Human Resources Forms

These documents should not be modified without consent from Human Resources

Frequently Used Forms

Direct Deposit

Dual Employment Request Form (CT-HR25)

Name/Address/Phone Change Form

W-4 CT State Tax & Federal Tax Forms

Work History Form

Tuition Waivers

Tuition Waiver Form for Unclassified Employees (AAUP, SUOAF, Management/Confidential)

Graduate-Level Educational Assistance Tax Reporting Requirements 

 Tuition Reimbursement - Classified Employees Only


For additional information on the Classified Scholarship Program, please contact Mary Cavanaugh, University Human Resources Administrator, (860) 832-1856.

Employment Forms

Background Check and Authorization


Faculty Forms

Part-Time Faculty Hiring Forms

University Assistant Appointment Forms

Search Forms


Faculty Related Forms

Evaluation Forms

AAUP Evaluation Forms

Classified Employee Evaluations Forms

Medical Related Forms

For additional FMLA information contact Victoria Karwowski in Human Resources, at (860) 832-1759.

Retirement Forms

Tier 3 and Hybrid Credit Purchase (CO-991)

Voluntary Schedule Reduction Program

Workers’ Compensation