Human Resources Forms
These documents should not be modified without consent from Human Resources
Frequently Used Forms
Dual Employment Request Form (CT-HR25)
Name/Address/Phone Change Form
W-4 CT State Tax & Federal Tax Forms
Tuition Waivers
Tuition Waiver Form for Unclassified Employees (AAUP, SUOAF, Management/Confidential)
Graduate-Level Educational Assistance Tax Reporting Requirements
Tuition Reimbursement - Classified Employees Only
Scholarships
- Classified Employee and/or Dependent Child Announcement Letter
- Classified Employee and/or Dependent Child Scholarship Award Guidelines
- Classified Employee Scholarship Application
- Classified Employee Dependent Child Application
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
Classification
Faculty Forms
Part-Time Faculty Hiring Forms
University Assistant Appointment Forms
- University Assistant Appointment Form (2022-23) Effective 7/1/2022
Search Forms
Faculty Related Forms
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Faculty Consulting and Research with Private and Public Entities FAQ’s
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Procedure for Reporting of Research or Consulting with Outside Public or Private Entity
- Employee Information Sheet
Evaluation Forms
AAUP Evaluation Forms
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Coach and Non-Instructional Athletic Trainer Evaluation & Recommendation for Renewal & Promotion
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Counselor Evaluation & Recommendation for Renewal, Tenure, Promotion or Professional Assessment
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Librarian Evaluation & Recommendation for Renewal, Tenure, Promotion or Professional Assessment
Classified Employee Evaluations Forms
Medical Related Forms
- Health Enhancement Program Plan Enrollment Form - (CO-1314)
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Military Family Leave – Employee – Attachment
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Sick Leave Bank Grant Application – AAUP – Attachment
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Sick Leave Bank Grant Application – Management/Confidential - Attachment
For additional FMLA information contact Victoria Karwowski in Human Resources, at (860) 832-1759.
Retirement Forms
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Limited Durable Power of Attorney Pre Retirement Form (CO-1049)
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Retirement Credit Purchase Request for Prior Miscellaneous Services Form
Tier 3 and Hybrid Credit Purchase (CO-991)
Voluntary Schedule Reduction Program
Workers’ Compensation
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DAS Form 207 - First Report of Injury
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DAS Form 207-1 - Incident Review Report
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WCC Form 1A - Filing Status and Exemption
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DAS Form PER-WC 211 - Concurrent Employment and Third-Party Liability
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DAS Form WC-715 - Request for Use of Accrued Leave With Workers' Compensation
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DAS Form 208 – Worker Status Report